Full text of "The Canadian Nurse Volume 67"

January 1971 



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Nurse 





Happy New Year! 

Nursing — evolution 
or revolution? 

Congenital rubella 

— an approach to preventio 





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2 THE CANADIAN NURSE 



I 

JANUARY 1971 



The 

Canadian 
Nurse 



^ 

^^p 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses' Association 



Volume 67, Number 1 



January 1971 



27 CNA Report to the Minister of Health on the 
Recommendations of the Task Forces on 
Cost of Health Services 

3 1 Information for Authors 

32 Nursing — Evolution or Revolution? L.C.Ford 

38 Congenital Rubella — One Approach to Prevention W.M. Reid 

4 1 Selection and Success of Students in a 

Hospital School of Nursing E.A. Willett, Rev. P.A. Riffel 

L.J . Breen, Sister E.J . Dickson 

46 Idea Exchange P.Hayes 

47 MEDLARSandYou A.D.Nevill,M.L. Parkin 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 



4 Letters 
1 7 Names 
23 In a Capsule 



7 News 
22 Dates 
64 Index to Advertisers 



Executive Director: Helen K. Mussallem • 
Editor: Virginia A. Lindabury • Assistant 
Editor: IJv-Ellen Lockeberg • Production 
Assistant: Elizabeth A. Stanton • Circula- 
tion Manager: Beryl Darling • Advertising 
Manager: Ruth H. Baumel • Subscrip- 
tion Rates: Canada: one year, $4.50; two 
years, $8.00. Foreign: one year, $5.00; two 
years, $9.00. Single copies: 50 cents each. 
Make cheques or money orders payable to the 
Canadian Nurses' Association. • Change of 
Address: Six weeks' notice; the old address as 
well as the new are necessary, together with 
registration number in a provincial nurses' 
association, where applicable. Not responsible 
for journals lost in mail due to errors in 
address. 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in India ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles 
sent, nor to indicate definite dates of 
publication. 

Postage paid in cash at third class rate 
MONTREAL, P.O. Permit No. 10,001. 
50 The Driveway, Ottawa 4, Ontario. 
C Canadian Nurses' Association 1970. 



r 



Guest Editorial 



JANUARY 1971 



As you are aware, the Report of the 
Royal Commission on the Status of 
Women was tabled in Parliament on 
December 7. The Prime Minister stated 
that the Government would study it 
before making any decisions in regard 
to its recommendations. 

Regardless of differences of opinion 
that may be held on various recom- 
mendations, this could be a very im- 
portant document as far as the po- 
sition of Canadian women is concerned. 
For example, if implemented, the pro- 
gram of day care centers could be vital 
in protecting the home, the children, 
the mother, and society, which must 
bear the ultimate burden of neglect. 
Many other recommendations could 
be extremely useful in helping women 
to achieve the position of equality 
with men which is essential in today's 
world. 

As the only woman Member now 
in the House of Commons, I am deeply 
concerned that Parliament may fail to 
give this matter the priority it needs. 
Your help in getting action is essential. 
Many women's groups appeared before 
the Commission and presented their 
views. A strong and sustained campaign 
by your organization is crucial now for 
the success of the Report. 

As a beginning, I would suggest a 
"write-in" campaign as soon as Par- 
liament reconvenes about mid-January. 
Letters and petitions should tlood the 
office of the Prime Minister, House of 
Commons, Ottawa, urging legislation 
on the Report this session. And if your 
Member of Parliament needs conver- 
sion to the recommendations (I do not!) 
a letter to him would be useful as well. 

On the principle of first things first, 
your letter might deal with two specif- 
ic matters: 

The first is to urge that a Minister 
of the Cabinet be designated to consid- 
er the Report as a whole and assign 
the responsibility for legislative action 
to the appropriate departments of 
government. 

The second is to press for immediate 
action to secure a program of day care 
centers as the first step in a broader 
scheme of child care as recommended 
by the Commission. This was the 
single item most often requested by 
Canadian women in their briefs to the 
Commission. 

But let me urge the absolute neces- 
sity of action now. Otherwise there is 
grave danger of this fine Report slipping 
into one of those forgotten filing cab- 
inet drawers. — Grace Maclnnis, 
M.P., Vancouver-Kingsway. 

THE CANADIAN NURSE 3 



letters 



Letters to the editor are welcome. 

Only signed letters will be considered for publication, but 

name will be withheld at the writer's request. 



Editor's Note: Copies of tite Canadiun 
Nurses' Association's Stand on The 
Physician's Assistant were sent to 
many other professional associations 
and to individuals concerned with 
health care. We believe some of the 
responses would be of interest. 

I am in complete agreement with this 
statement and wish to associate myself 
fully with your stand. Having had a 
great deal of experience outside Canada 
in the use of various categories of health 
workers. 1 cannot see the need for the 
development of a separate category 
of individual for the physician's assis- 
tant or associate. 

It seems to me that many members 
of the medical profession have not, in 
the past, fully used the modern well- 
educated nurse. In many instances, the 
nurse has been operating at a level of 
responsibility which is far below that 
of her training. 

Quite clearly, the best person to 
operate as a physician's assistant is 
the nurse, and we should use this pool 
of experience and devotion for the 
development of health services. . . . 

It appears to me there are too many 
academics involved in the planning of 
our health services. There are very few 
of them who have actually run and op- 
erated a health service. 

If these people who advocate the 
development and traming of a physi- 
cian's assistant have the responsibility 
of running an efficient health service 
at a reasonable price, I do not think 
they will be so enthusiastic in trying to 
develop new personnel, manv of whom 
will find this a dead-end occupation. 
— W. Harding le Riche, M.D., M.P.H., 
professor and head, department of epi- 
demiology and biometrics. University 
of Toronto, Toronto, Ontario. 

From the discussions which our com- 
mittee has had about this matter I 
would think the feeling of the majority 
of doctors would be in line with the 
policy set out by your association. — 
Glen Sawyer, M.D., general secretary, 
Ontario Medical Association, Toronto. 

In my opinion, most doctors would 
take no exception to what is in your 
statement, which makes me wonder 
if the medical profession and the nurs- 
ing association are not agreed on the 
type of professional that should fill this 
intermediate role. 
4 THE CANADIAN NURSE 



Since your association is concerned 
about the term "physician's assistant," 
you might find that members of the 
medical profession are likewise con- 
fused as to what is really meant by 
this term. It is obvious more dialogue 
will be necessary in the near future. — 
D.L. Kippen, M.D., president, Cana- 
dian Medical Association, Ottawa. 

A copy of the CNA statement on the 
physician's assistant has been mailed 
to the dean of every Canadian Medical 
school. — John B. First brook, M.D., 
Ph.D.. executive director, The As.so- 
ciation of Canadian Medical Colleges. 

Telegram supports abortion reform 

November editorial superlative. Con- 
cur CNA needs to take a visionary stand 
on the abortion issue for removal from 
Criminal Code. Inherent are the eco- 
logical and social concerns of popula- 
tion control through education. Health 
personnel, ethical codes, and World 
Health Organization definition of health 



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OTTAWA 4, Canada 



should be guides to effective actioi 
rather than statutory laws. — Dr. Shir 
ley R. Good, Director, School of Nitrs 
ing. University of Calgary, Calgary 

A student who cares 

Recently, my patient assignment in 
eluded a very old, blind, and partiallj 
immobilized man. I have never criec 
as much in my whole life as I did wher 
caring for this patient, who groped foi 
all the caring and love he could get. 
grew to love him, as he needed to bt 
loved so much. 

I did not cry because I felt sorrjx 
for him, but because this old man, in 
significant as he sounds, made me 
really think for the first time abou 
how little love there is, even in tht 
world of nursing. 

Little things mean so much to peo 
pie who need to be loved. Once II 
brought my patient a rose that my boy 
friend sent me on St. Patricks Day 
When I approached him, I told him I 
had a present for him. He looked un 
happy and said to me, "But I can't set 
it, I'm blind." I said, "I know, but 1 
want you to smell it and feel how sofi 
it is." He did, and I felt like a millior 
dollars. 

I do not believe many prople car 
take the time to sit down and think 
about loving and caring for people 
I realize how fortunate 1 am to be £ 
nurse and to be exposed to this tremen- 
dous need for love. 

I did not feel sorry for this man, bui 
I did identify with him. I saw how selfish 
I must have been before meeting him. 
I sometimes find myself thinking about 
all the caring that is needed in this 
world for people who can, should, and 
need to be loved. If this love could be 
given, it would bring fullness to many 

I washed this patient's socks, scrupu- 
lously cleaned nis dentures, and telt 
pleased at his reactions. I told him he 
had other senses to make up for his 
blindness. When he smiled, squeezed 
my hand, and laughed, he gave me 
so much. 

I learned much about myself when 
caring for this elderly patient. Now 
I realize how secondary practical know- 
ledge can be when compared to self- 
understanding. It takes a long time to 
know yourself, but when you do you 
never forget what you have learned — 
Shannon Cruikshank, second-year 
nursing student at St. Joseph's School 
of Nursing, Hamilton, Ontario. '§ 

JANUARY 197- 






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Social and Economic Welfare 
Committee Meets At CNA House 

Ottawa — The White Paper on Tax- 
ation, a nurse lobbyist, unemployment 
insurance legislation, means whereby 
staff turnover may be minimized, were 
discussed at length by the standing 
committee on social and economic 
welfare of the Canadian Nurses" 
Association at its meeting November 9 
and 10. 

David Weatherhead. MP- chairman 
of the House of Commons standing 
committee on labor, manpower, and 
immigration, was on hand to answer 
questions on the subject of the inclusion 
of nurses within the legislation on un- 
employment insurance. 

The CNA standing committee is 
comprised of the chairmen of the pro- 
vincial committees on social and eco- 
nomic welfare as follows: chairman, 
Marilyn Brewer of New Brunswick; 
Louise Nicholas of Newfoundland; 
Frances Reese of Prince Edward Island; 
Roy Harding of Nova Scotia; Berna- 
dette LeBlanc of New Brunswick; 
Gertrude Hotte and Sheila O'Neill of 
Quebec; Margaret O'Connor of On- 
tario; Shirley J. Paine of Manitoba; 
Evelyn Fyffe of Saskatchewan; Iris 
Mossey of Alberta; and Rosemary 
Macfadyen of British Columbia. 

CNA Board Sets Up Committee 
To Study French-Language Texts 

Ottawa — An ad hoc committee is 
being set up by the Canadian Nurses' 
Association's board of directors to 
develop means of encouraging the 
publication and translation of French- 
language textbooks. 

The decision was made by the board 
at its meeting October 7-9, 1970. Hu- 
guette Labelle, CNA second vice-pres- 
ident, was appointed chairman of the 
committee. 

The setting up of the committee 
results from a resolution passed by del- 
egates at the CNA 35th general meet- 
ing which said, ". . . that the CNA board 
of directors consider as a priority ways 
and means of encouraging the produc- 
tion of textbooks in the French lan- 
guage." 

Members of the ad hoc committee 
as approved by the board are: Claire 
Bigue, editor, L'infirmiere canadienne; 
Margaret Parkin, CNA librarian; a 
representative from Ontario and one 
from New Brunswick; and three from 
JANUARY 1971 



Quebec, to include one from the Uni- 
versity of Montreal, Laval University, 
and a CEGEP school. 

At the board's request Mrs. Labelle 
outlined some of her ideas for the com- 
mittee. She believes CNA should act 
as a catalyst in attempting to get French- 
language textbooks published, and 
said the committee would compile a 
list of publications available in French. 
(Already underway is a revision of a 
list of French-language textbooks and 
publications prepared in 1967 by 
Miss Parkin.) 

Mrs. Labelle said the committee 
would also look at translations that 
are in the offing. It could then devise 
a tool, such as a questionnaire, to be 
sent to institutions where French-lan- 
guage textbooks are required, to iden- 
tify the need. 

The questionnaire would also as- 
sess the willingness of institutions and 
individuals to participate and coop- 
erate in such an undertaking, said Mrs. 
Labelle. 

She believed the next step would 
be to study possible sources for fin- 
ancing translation and publication, 
possibly obtaining assistance from 
publishers, individuals, and institutions 
willing to cooperate. 

CNA Film Available 
Through Local Chapters 

Ottawa — The Leaf and the Lamp, a 
20-minute, sound, color film commis- 
sioned by the board of the Canadian 
Nurses" Association in March 1970, 
is now available. 

This film depicts how a nurse, through 
participation at her local chapter level, 
can strengthen the profession and con- 
tribute to improvements in nursing. 
It shows the activities that have been 
generated and what has been achieved 
by the individual nurse through mem- 
bership in her professional association. 

The Leaf and the Lamp, in English 
or French, is intended for showings 
to nursing groups, free of charge. When 
ready for general distribution, all chap- 
ters will have been furnished with de- 
tailed information. 

CNF Board Of Directors 
Hears Membership Up 

Ottawa — Finance and membership 
always loom large in the affairs of the 
Canadian Nurses' Foundation. This 



was no exception when the CNF board 
of directors met November 10, 1970 
at CNA House. 

Dr. Helen K. Mussallem, secretary- 
treasurer of CNF, reported the founda- 
tion is assured of annual financial 
support from the provincial nurses' 
associations of British Columbia, Al- 
berta, Saskatchewan, and Manitoba. 

These provincial contributions will 
provide over $30,000 annually. Dona- 
tions from all sources, unless identi- 
fied for research, are credited to fellow- 
ship funds. 

Discussing awards, Dr. Mussallem 
said 1 9 of the 20 awards approved by 
the board in May were accepted. Four 
fellowships were reduced in amount 
because of receipt of financial help 
from other sources. In all, fellowships 
awarded in 1970 totalled $59,737. 

As of November 1, membership in 
CNF totals 1,429, an increase of 118 
over 1969. 

Plans are underway for a program to 
celebrate CNF's 10th anniversary with 
a program at the Canadian Nurses' 
Association general meeting in 1972. 

The selections committee, the nom- 
inating committee, the board of direc- 
tors will all meet early in May prior 
to the CNF annual meeting. 

At the annual meeting three pro- 
posals will be presented in the form of 
bylaw amendments. These proposals 
will deal with an increase in member- 
ship fee, the composition and terms of 
reference of the research committee, and 
a requirement that CNF membership 
be compulsory for committee members. 

Hester J. Kernen is CNF president, 
with Albert W. Wedgery as vice-pres- 
ident. Members of the board are J. 
Alice Beattie, Sister Marie Bonin, Jean 
Church, Dorothy Dick, E. Louise 
Miner, M. Geneva Purcell, and Ma- 
rion C. Woodside. 

This board completes its term in 
1971 and a new board will be elected 
at the annual meeting on May 17. 

Travel Seminars To Be Held 
For Nurse Educators 

Ottawa — The medical services branch 
of the department of national health 
and welfare is conducting a special 
project in nursing in the form of "travel 
seminars" for a number of nurse edu- 
cators. 

The participants, drawn from uni- 
versity school of nursing faculties, will 
have orientation at one of three centers, 
THE CANADIAN NURSE 7 



news 



Edmonton, Montreal, or Winnipeg, 
before proceeding to assignments in 
isolated nursing stations. The seminars 
will take place in January, February, 
and March, 1971. 

The purpose of the project is to pro- 
vide an opportunity for nurse edu- 
cators to observe and participate in 
nursing programs for people in iso- 
lated areas. It is anticipated that this 
will enable them: l.to interpret the 
needs to students; and, 2. to adapt and 
expand the education of nurses to meet 
the needs of all Canadians. 

The medical services branch hopes 
these seminars will be the first of a 
number that will involve other schools 
of nursing. 

The Canadian Nurses' Association 
will be represented by its president, 
E. Louise Miner, and first vice-presi- 
dent Kathleen G. DeMarsh. 

ANPQ Resolutions 
— Forty Of Them! 

Montreal, Quebec — Promotions in the 
clinical area, a need to be heard, and 
members' fees to the Association of 
Nurses of the Province of Quebec were 
among important subjects discussed 
when 40 resolutions were dealt with at 
the asstKiation's annual meeting No- 
vember 2-4. 

If interested in bedside care, a nurse 
should not be obliged to climb the 
impersonal ladder of administration 
for promotions to come her way. This 
prompted the ANPQ to recommend 
the granting of promotions "according 
to various levels in the clinical area in 
order to improve the clinical compe- 
tence of the nurse, i.e., bedside nurse, 
team leader, nurse clinician." 

The ANPO resolved to recommend 
strongly to Quebec's minister of health 
that a representative suggested by the 
ANPQ be named to the Health Insur- 
ance Board. The association firmly 
believes that a professional corporation 
with more than 30,000 members, who, 
among them, work in all areas included 
in the Health Insurance Scheme, be 
given representation on its board. 

Balancing the budget is the prime 
responsibility of any business enter- 
prise. The ANPQ's budget is so finely 
honed that its revenues must be in- 
creased — additional fees from mem- 
bers could be the answer. It was there- 
fore resolved that the ANPQ consider 
the needs and the complexities of a 
possible fee increase, and present its 
findings at the next annual meeting, 
and that each district also study this 
matter to bring feedback to the ANPQ 
8 THE CANADIAN NURSE 



ANPQ Honors Past Presidents 




Ten living past presidents of the Association of Nurses of the Province of Que- 
bec were honored at a reception at the Queen Elizabeth Hotel, Montreal, in 
conjunction with the 50th anniversary of the association. As a memento, each 
was presented with the a sculpture of a nurse. Here, Caroline V. Barrett, ANPQ 
president from 1932 to 1936. receives her gift from Ann Arundel-Evans, staff 
nurse at the Queen Elizabeth Hospital. Looking on are ANPQ President Helen 
D. Taylor and immediate past president, Madeleine J albert. More than 500 
attended this reception, the first event of the three -day anhual meeting of the 
association. The past presidents honored were, in order of holding office: 
Miss Barrett, Eileen C. Flanagan, Annonciade Martineau-Bergcron, Eve 
Merleau. Margaret M. Wheeler, Sister Mance Dccary, Heiene M. Lamont, 
Gertrude Jacobs, Miss Jalbert, and Miss Taylor, the current president. 



from the members at large, so that all 
opinions may be considered at the next 
annual meeting. 

Many of the other resolutions spark- 
ed interesting discussions that in most 
cases led to referral to a committee 
such as that of management for further 
study or action. 

ANPQ President Says Nurses 
Must Decide Own Future 

Montreal, Quebec — Determining the 
social usefulness of nurses of the future 
must remain the challenge of nurses 
themselves, individually and collective- 
ly. This was the core of Helen D. Tay- 
lor's address to the 50th annual meeting 
of the Association of Nurses of the 
Province of Quebec, held at the Queen 
Elizabeth Hotel in Montreal Novem- 
ber 2-4. 

Miss Taylor, who is serving her 
second term as ANPQ president, said 
that although nursing needs to func- 
tion interdependently with all health 
professions, it does not follow that 
solutions to the problems of other pro- 



fessions apply to nursing or that other 
professions should be encouraged to 
make decisions affecting nursing. 

Nurses today are faced with a dilem- 
ma as to their future role. Miss Taylor 
said. Are they to be givers of tender- 
ness, or are they to be doctors" assist- 
ants'.' They must demonstrate a willing- 
ness and an ability to share in the tech- 
nological advances of the medical 
sciences, and at the same time give 
expert personal care and grow pro- 
fessionally. Otherwise, she said, the 
medical practitioner and the public 
may lack confidence in the nurses' abil- 
ity to cope with future demands. 

Miss Taylor said the nursing pro- 
fession needs representatives who are 
informed, articulate, and able to con- 
tribute. She urged individual nurses to 
accept the basic obligation to become 
informed, not only on matters directly 
affecting nursing care, but on those 
affecting health, such as social health 
problems, safety health measures, and 
political and legislative issues. 

(Continued on page 10) 
JANUARY 1971 



for use 
-on the ward 
-in the OR 



-in training 



NEOSPORIN^ 

IRRIGATING 

SOLUTION 

Available: Sienle Icc Ampoules. 
Boxes of 10 and 1CX> 

INSTRUCTIONS FOR USE 

This piewation is tp*C'!ic«ltv (JBiigT^ed 'Of oM with 5 cc. 
■tnre«-i«»v' c«hetef» ix with othw cAtnaiet sv»i»ms permn- 
ting continuous irrigation of th« unncry UwMm 

1 PRCPARE SOLUTION 

Using cicrilt piecAuliont. on« (1 ) cc. of Neosponn Irrrga- 
tiog Solution ihouM be added to a 1 .000 cc bottle of 
sienla isotonic salm* solution 

2 INSERT INDWELUNG CATHETER 

C«tnet«fii« the patient using full sterile precautions. The 
i/se of an antibacterial lubricant such as Lubasoorin* Uretfiral 
Aniibaaenal Lubricant is recommefKted during insertion ol 

INFLATE RETENTION BALLOON 

Fill a Luei type tyringe with 10 cc. of sterile water or s«line 
(5 CC lor balloon, the lemaindei to compensate tor the 
I required bv the mtlalion channel) Insert syimge 

syringe 

PONNECT COLLECTION CONTAINER 

e outflow (drainage) lumen should be asepiically con- 

a a sterile disposable plastic lube, to a sterile 
wsaUe plastic collection bag (bottle) 

ACH RINSE SOLUTION 

nflow lumen of the S cc Ifiree-way cathetei should 
be connected to the bottle of diluted Neosporin 

prigaI>on Solution using xietile technique 

FaDJUST FLOW-RATE 

' for most palienis inttow rale of the diluted Neosporih 
Irrigating Solution should be adjusted to a siow drip to 
deliver about 1,000 cc every twenty four hours {about 
<0 cc per hour) If the patient s unne output exceeds 2 
lit*rs per day it is recommended that the inflow rate be 
■diuited lo deliver 2.000 cc of (he sotution .n a twenty- 
four hour period This requires the addition of an ampoule 
of Neosporin irrigating Solution lo each of two 1,000 cc 
bottles of sterile salme solution 

KEEP IRRIGATION CONTINUOUS 

II It important that irrigation of the bladder be continuous 
The rinse t>ot1le should never be allowed to run dry, or the 
inflow d'lp interrupted for more than a few minutes The 
outflow lube should always be inserted into a st»ri)e 
COniBtiar 

Convenient product identify ir>g labels for use on bottles 

of diluted Neosporin Irrigating Solution are available in each 

ampoule packing or from your B. W. ft Co.' Representative 




Burroughs Wellcome & Co. (Canada) Ltd. 



KtaMKll .MAC 1 



Neosporin' Irrigating Solution 



INSTRUCTIONS FOR USE 



Designed especially for the nursing pro- 
fession, this Instruction Sheet shows 
clearly and precisely, step by step, the 
proper preparation of a catheter system 
for continuous irrigation of the urinary 
bladder. The Sheet is punched 3 holes to 
fit any standard binder or can be affixed 
on notice boards, or in stations. 

For your copy (copies) just fill in the cou- 
pon (please print) noting your function or 
department within the hospital. 



Dept. S.P.E. 

Burroughs Wellcome & Co. (Canada) Ltd. 

P.O. Box 500, Lachine, P.O. 

Gentlemen : 

Please send me I I copy (copies) of the N.I S Instructions for Use. My department or function 

within the hospital '^ 



NAME. 



ADDRESS. 



CITY OR TOWN. 



.PROV. 



I PMAC I 

'Trade Mark 

JANUARY 1971 




Burroughs Wellcome & Co. (Canada) Ltd. 

** THE CANADIAN NUR5b 




(Continued from page 8) 

The ANPQ president then mentioned 
progress being made in nursing in Que- 
bec: the recognition of male nurses 
through a 1 969 amendment to the Que- 
bec Nurses' Act; the growing awareness 
of the role of the nurse in public health 
and in the prevention of disease; the 
acceptance of the concept of collective 
bargaining; the freeing of nursing from 
many tasks not requiring a nurse's spe- 
cial skills and technical knowledge. 

The tone for the ensuing meeting 
was set by Miss Taylor's closing re- 
marks: "We [as nurses] can be justi- 
fiably proud of our past, but let us 
really show that we are prepared to 
render far greater services in the years 
ahead." 

A Book Is Born 
In French 

Montreal, Quebec — The history of 
the nursing profession in the Province 
of Quebec, Histoire de la profession 
infirmiere dans la province de Quebec, 
came off the press in time to coincide 
with the golden anniversary of the 
Association of Nurses of the Province 
of Quebec. 

The book is first an overview of 
medical and nursing lore from ancient 
times; then, a story of nursing gener- 
ally from the Roman era to the found- 
ing of New France, and more particu- 
larly from the ministrations of Jeanne 
Mance to the hospital services of the 
20th century; and, finally, a doc- 
umented and detailed description of the 
origins and history of the ANPQ from 
its inception in 1920 to the present. 

Written by one of Canada's most 
distinguished medical journalists, Dr. 
Edouard Desjardins, emeritus pro- 
fessor of surgery, University of Mont- 
real, editor-in-chief of Union Medicale, 
honorary archivist and librarian of the 
Royal College of Physicians and Sur- 
geons of Canada, the book required 
two years in the making. 

In 1968, the committee of manage- 
ment of the ANPQ assigned Eileen 
Flanagan, former president of the AN- 
PQ, and Suzanne Giroux, formerly an 
executive with the ANPQ, to organize 
this project. Now one step remains: to 
translate this volume into English for 
publication later this year. 

Information Seminar Held 
On National Health Grant 

Ottawa — Modified terms of reference 
for the federal government's National 
Health Grant were discussed with pro- 
vincial representatives and health and 
10 THE CANADIAN NURSE 




Miss Flanagan autographs the first 
copy of "Histoire de la profession in- 
firmiere dans la province de Quebec" 
for Judge Roger Ouimet, former legal 
consultant of the ANPQ. 



educational authorities at a one-day 
meeting in November. 

National health and welfare min- 
ister John Munro said the national grant 
has provided funds for some 87 research 
projects designed to improve health 
care for Canadians. The program has 
been in operation for two years. The 
grant's 1970/71 budget is $2,100,000. 

Dr. J. Maurice LeClair, deputy min- 
ister of national health, reviewing the 
general objectives of the program said, 
"The national health grant is concerned 
with research, demonstration and pilot 
projects, and training personnel. This 
means a good methodology and evalua- 
tion of results . . ." 

The grant's terms of reference in- 
clude provision of financial assistance 
for operational research in such areas 
as better utilization of health manpower; 
better management and coordination of 
health delivery systems; and recruit- 
ment, training, and development of 
research personnel. 

Speakers included Dr. G. Malcolm 
Brown of Ottawa, president. Medical 
Research Council; Jean-Yves Rivard, 
professor, department de I'adminis- 
tration de la sante, Universite de Mont- 
real; Dr. David L. Sackett, professor, 
department of clinical epidemiology 
and biostatistics, McMaster University; 
Dr. Aurele Beaulnes, recently named 
to coordinate federal health depart- 
mental activities concerning non-med- 
ical use of drugs and professor, depart- 
ment of pharmacology and therapeu- 
tics, McGill University; Dr. Peter Ru- 



derman, professor, health administra- 
tion, school of hygiene, University of 
Toronto; and Dr. J.A. Dupont, assistant 
director, health grants, department of 
national health and welfare. 

Health associations represented in- 
cluded the Canadian Medical Asso- 
ciation, Canadian Dental Association, 
Canadian Hospital Association and the 
Canadian Nurses' Association. Dr. 
Helen K. Mussallem represented CNA. 

Dr. John R. Evans, dean, faculty of 
medicine, McMaster University, was 
chairman. 

AARN Warns Nurses 
Of Job Shortage 

Edmonton, Alta. — There are practi- 
cally no nursing positions available in 
Alberta cities, said the Alberta Asso- 
ciation of Registered Nurses. However, 
there are still a few openings in rural 
areas, in the northern part of the prov- 
ince, and in the Northwest Territories, 
AARN points out. 

Because of the scarcity of nursing 
jobs, the association is warning nurses 
outside the province not to seek work 
in Alberta. Doris Price, registrar of 
AARN, said a nurse from another 
province should come to the province 
only if she already has a job. 

Statistics compiled in an AARN 
survey show that most of the recent 
1970 graduates of schools of nursing 
in the province are employed. 

Speakers And Panelists Announced 
For Research Conference 

Vancouver, B.C. — Two of North 
America's leading nurse researchers 
— Dr. Faye G. Abdellah and Dr. Lo- 
retta E. Heidgerken — will give the 
highlight presentations at Canada's 
first national conference on research 
in nursing practice to be held in Ottawa 
February 16-18, 1971. 

Dr. Abdellah is the chief nurse offi- 
cer and assistant surgeon general of 
the United States Public Health Serv- 
ice, and associate director for health 
services development in the National 
Center for Health Services Research 
and Development. At the Ottawa con- 
ference, which is intended to bring 
Canadian nurses together for the pur- 
pose of stimulating research in nursing 
practice in Canada, Dr. Abdellah will 
speak on "The Development of Nursing 
Research in the Society." 

Dr. Loretta E. Heidgerken, profes- 
sor of nursing education, The Catholic 
University of America School of Nurs- 
ing, Washington, D.C., will discuss 
"The Research Process" at the Ottawa 
conference. 

Canadian nurses who will present 

papers, act as chairmen, or as panelists 

include: Dr. Floris E. King, project 

director of the conference; Dr. Amy E. 

(Continued on page 14) 

JANUARY 1971 



Up-to-date information 
to lielp you & your patients 



Pharmacology for 
Practical Nurses, 3rd Edition 

By Mary Kaye Asperheim, B.S., M.S., M.D. 



A new edition of this outstandingly useful text. The 
author discusses drugs in relation to body systems and 
their diseases; she describes the physical forms of the 
drugs, the usual dosage, methods of administration, 
symptoms of overdosage, and abnormal reactions which 
may arise. This third edition includes a chapter on 
antineoplastic drugs, and the drug descriptions and 
dosage reflect the latest research. 

171 pages illustrated. About $3.80 Ready January 1971. 



Mayo Clinic Diet Manual 
4th Edition 

By the Committee on 
Dietetics of the Mavo Clinic 



Here is the new edition of the most popular and respected dietetic 
guidebook available today. This manual presents the latest 
concepts in treatment of diseases requiring dietary regulation. 
It has been revised and expanded to take into account recent 
advances in nutrition. A fundamental change is the use of the 
Mayo Clinic Food Exchange List as the basis for planning most 
therapeutic diets. 

About 170 pages. About $7.30. Ready January 1971. 



The Management of Patient Care: 

Putting Leadership Skills to Work, 3rd Edition 



By Thora Kron, R.N., B.S. 



This text, called Nursing Team Leadership in previous editions, is designed to 
show the professional nurse the many ways she may exercise leadership in 
the management of patient care. New material includes methods to help the nurse 
become more efficient in arranging supplies and equipment, in studying and 
revising nursing technhiques, in delegating activities to members of the nursing 
staff, and in planning her own activities. 

About 208 pages, illustrated. About $3.80. Ready January 1971. 



The Nursing Clinics of North America 



The Patient with Tramna 

Janet Finnegan Carroll, Guest Editor 



The Nurse in Community 
Mental Health 

Lorene R. Fischer, Guest Editor 



The December issue of this famous hardbound periodical carries 
16 articles on topics of vital importance to nurses. Each article 
covers a specific aspect of the subject of the symposium. This 
issue includes an article on the battered child by Joan Hopkins, 
and one on cooperation between nurses and community members 
in community mental health clinics, by Hilda Richards and 
Naomi Hargrave of Harlem Hospital. The Clinics provide a 
continuing source of information for the practicing nurse. 

Published four times yearly. Averages 185 pages per issue, with no 
advertising. Hardbound. Available only by yearly subscription. $13. 



W. B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7 

Pleose send on approvol and bill me: 

D Asperheim, Pharmacology for Practical Nvnoi ($3.80) 

D Mayo Clinic Diet Manual ($7.30) 

O Kron, Management of Patient Care ($3.80) 

□ Enter my subscription to Nursing Clinics, to begin with the December issue ($13.) 

Name: 

Address: 

City: ..........V— "--"T"--- ...—,.. 




Zona; Province: 



JANUARY 1971 



CN 1011 
THE CANADIAN NURSE 11 

% 




«f 




^u^^^ 



I 



She is needed 
here and now. 

Why 

send her away 

for training ? 



Complete in-hospital training 

of the coronary-care nurse 

is now possible with the 

ROCOM ecu Multimedia Instructional System 



* 



Constant care, early detection, 
effective treatment: tiiese are 
essential to any Coronary Care 
Unit. They come about only 
through special training in the 
necessary life-saving skills. 

The ROCOM CCU Multimedia 
System, as its name suggests, 
employs several forms of instruc- 
tion and communication: motion 
pictures, sound film strips, audio- 
tapes and texts comprising lec- 
tures, demonstrations, problem- 
solving and evaluation proce- 
dures. 

Some hospitals conduct their 
own in-service training pro- 
grammes for CCU nurses using 
traditional time-consuming teach- 
ing methods; many others have 
to send their nurses away for 
training. Both these methods cost 
more in time and money than they 
ought to, involve personnel in 
non-therapeutic activities and, in 
the second case, remove needed 
nurses from the hospital. 

The ROCOM System lets the 
hospital train its own nurses 
without sending them away — 
without losing their services for 
several weeks. It permits tradi- 



tional centres to do a quicker, 
more efficient job. 

The ROCOM CCU Multimedia 
Instructional System's "hard- 
ware" consists of a movie pro- 
jector, a rear-screen device and 
a sound filmstrip projector, each 
the simplest, most trouble-free of 
its kind. 



For further information or de- 
monstration please write to Pro- 
fessional Services Department, 
Hoffmann-La Roche Limited, 1956 
Bourdon Street, Montreal 378, 
Quebec. 

*fhe basic CCU course, "Intensive Coro- 
nary Care — A Manual for Nurses" 
(Meltzer, Pinneo, Kitchell), expanded 
and brought up to date. 




news 



(Continued from page 10) 

Griffin; Mme M. Castonguay-Thebi- 
deau; Dr. Beverly DuGas; Dr. Dorothy 
J. Kergin: Pamela E. Poole; Dr. Moyra 
Allen; Mme Nicole Beland-Marchak; 
Dr. M. Josephine Flaherty; Kathleen 
G. DeMarsh;M. Geneva Purcell;Verna 
M. Huffman; Dr. Margaret C. Cahoon; 
and Dr. Helen K. Mussallem. 

The February conference, sponsored 



by the school of nursing of the Univer 
sity of British Columbia and funded by 
a federal government grant, will be bi- 
lingual. 

Physicians, Administrators 

Join Nurses In Hamilton Seminar 

Hamilton, Out. — If they agreed on 
little else, panelists at the seminar 
"Nursing — Today and Tomorrow," 
held at the Henderson General Hospi- 
tal October 29, did share the belief 
that planning for the future should 
begin now. 

Panel members included Norma 
Wylie, director of nursing, McMaster 




I Hoilister's complete 

U-BAG 



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14 



gel any infant urine specimen when you wani ii 

The sure way to collect pediatric urine specimens 
easily . . . every time . . . Hoilister's popular U-Bag 
now has become a complete system. Now, for the 
first time, a UBag style is available for 24hour as 
well as regular specimen collection, and both styles 
now come in two sizes ... the familiar pediatric size 
and a new smaller size designed for the tiny contours 
of the newborn baby. 

Each UBag offers these unique benefits: ■ double 
chamber and noflowback valves ■ a perfect fit on 
boy or girl, newborn or pediatric ■ protection of the 
specimen against fecal contamination ■ hypo-aller- 
genie adhesive to hold the UBag firmly and comfort- 
ably in place without tapes ■ complete disposability. 

Now the UBag system can help you to get any infant 
urine specimen when you want it. Write on hospital 
or professional letterhead for samples and informa- 
tion about the new UBag system. 

HOLLISTER LIMITED, 160 BAY STREET, TORONTO 116, ONTARIO 

THE CANADIAN NURSE 



B 



University Medical Centre; Dorothy 
Kergin, director of the school of nurs- 
ing at McMaster; L. Coffey, assistant 
director of St. Joseph's School of Nurs- 
ing in Hamilton; and R.G. McAuley, 
assistant professor, family medicine, 
faculty of medicine, McMaster. S.W. 
Herbert, assistant director of the Mc- 
Master University Medical Centre, was 
panel moderator. 

Several panel members commented 
on the question of fear — the fear that 
both students and graduate nurses ex- 
perience in dealing with patients, and 
the fear that a patient and his family 
have about the illness. One physician 
said no matter what kind of training 
nursing and medical students get, they 
are still afraid at first. Miss Coffey 
agreed, adding that students must have 
the freedom to express their fears. 
The patient, too, must be helped to 
express his fear, another panelist com- 
mented. 

Another aspect of fear was pointed 
out by Miss Wylie. Referring to a cor- 
onary care unit in one hospital, she 
said nurses in this unit explain to the 
patient's family — and to the patient 
when he is able to cope — the gadgetry 
that will be used in treating him. The 
nurses believe this helps the patient 
and his family to express their fears, 
Miss Wylie said. A physician, question- 
ing whether such explanation was al- 
ways a good idea, recalled that one in- 
telligent patient was so depressed after 
all this explanation that he became al- 
most suicidal. 

The current controversy over whe- 
ther the nurse should be a generalist 
or a specialist sparked lively discussion. 
According to one speaker, "We seem 
to have come the full cycle: starting out 
with the generalist type of nurse, then 
moving into an era where nurses drop 
everything they don't consider as being 
pure nursing, and now going back to 
people saying they have to pick up the 
social aspects, dietary aspects, and 
welfare aspects of what was part and 
parcel of specialized fields before. Are 
nurses going to be trained to do specific 
tasks in the hospital or will they be 
generalists who pick up little bits and 
pieces from all the. other health profes- 
sions?" 

A member of the audience, Dr. Ralph 
Sutherland of Ottawa, predicted that 
in the next 10 years there will be a 
great deal of emphasis on what nurses 
should do in the medical field, but 
not so much concern about whether 
they do something that is outside the 
nursing field. He also predicted a growth 
in clinical specialist training below the 
baccalaureate level. "If that doesn't 
happen," he warned, "I feel the pro- 
fession is really in trouble. And, unfor- 
tunately, I do not see a move in that 

{Continued on page 16) 
JANUARY 1971 



Fleet 

ends ordeal by 

Enema 

for you and 
your patient 




Now in 3 disposable forms: 

* Adult (green protective cap) 

* Pediatric (blue protective cap) 

* Mineral Oil (orange protective cap) 

Fleet — the 40-second Enema* — is pre-lubricated, pre-mixed, 
pre-measured, individually-packed, ready-to-use, and disposable. 
Ordeal by enema-can is over! 

Quick, clean, modern, FLEET ENEMA will save you an average of 
27 minutes per patient — and a world of trouble. 



WARNING: Not to be used when nausea, 
vomiting or abdominal pain is present. 
Frequent or prolonged use may result in 
dependence. 

CAUTION: DO NOT ADMINISTER 
TO CHILDREN UNDER TWO YEARS 
OF AGE EXCEPT ON THE ADVICE 
OF A PHYSICIAN. 



In dehydrated or debilitated 
patients, the volume must be carefully 
determined since the solution is hypertonic 
and may lead to further dehydration. Care 
should also be taken to ensure that the 
contents of the bowel are expelled after 
administration. Repeated administration 
at short intervals should be avoided. 



Full intormation on request. 

•Kehlmann, W. H.: Mod. Hosp. 84:104, 1955 

FLEET ENEMA® — single-dose disposable unit 



r. 



lANUARY 1971 



kLiTV P»4AIIUACtUTICALa 
KSau^MCMOMTMCMl CANADA j 



THE CANADIAN NURSE 15 



news 



(Continued from page 14) 

direction yet." One of the major ob- 
structions, said Dr. Sutherland, is the 
nurse hangup that her image is tied to 
a baccalaureate degree. 

Emergency Department Nurses 
Form Association In Edmonton 

Edmonton, Alfa. — The Emergency 
Department Nurses" Association of 
Edmonton has been formed to improve 
inter-hospital communication, promote 
an awareness of and utilize commun- 
ity health resources available to emer- 
gency departments, promote unity 
among emergency department nursing 
personnel, and continue education of 
nurses. 

The association, which is open to all 
nursing personnel in emergency de- 
partments in the city's hospitals, will 
meet five times a year at the various 
hospitals. 

Course On Adolescence Discusses 
Sex, Parents, Epilepsy, Acne .... 

Vancouver, B.C. — Adolescents learn 
about sex mainly from friends. Nurses 
and doctors are a minor source of in- 
formation, Dr. George Szasz told 77 
nurses and their high school student 
guests at a continuing nursing educa- 
tion program on adolescence in October. 

The two-day program was conducted 
by the University of British Columbia's 
division of continuing education in the 
health sciences. Dr. Szasz is director 
of interprofessional education at the 
health sciences center and assistant pro- 
fessor and Milbank Faculty Fellow in 
the department of health care and epi- 
demiology. 

Dr. Szasz suggested nurses could be 
more helpfull to adolescents in sexual 
education, but that "nurses don't listen 
because then they become accessory 
after the fact." 

He said human sexual behavior con- 
sists of two aspects: social activities, 
such as dating, and sexual activities, 
which are capable of producing reac- 
tions in the body. The four types of 
sexual activity are solitary, hetero- 
sexual, homosexual and, more rarely, 
activity involving animals. 

Solitary activity was termed ex- 
ceedingly important, involving day- 
dreaming and role playing. Dr. Szasz 
said it is important for nurses to rec- 
ognize whether the adolescent is day- 
dreaming or is in acute depression. 

Nurses should be able to discuss 
masturbation with young people, he 
said, pointing out it does not harm the 
person and there is evidence it is 
16 THE CANADIAN NURSE 



beneficial to orgasm. Every boy mas- 
turbates by the age of 1 6. Less than a 
quarter of girls masturbate before 
age 16, but after that, 80 percent of 
girls masturbate, he said. 

Speaking on the physiology of ado- 
lescence. Dr. John Birbeck, assistant 
professor, department of pediatrics, 
faculty of medicine, UBC, said all 
physical changes in adolescence are 
accompanied by emotional and intel- 
lectual changes. Noting that "our 
society is unkind to late maturers." 
Dr. Birbeck said the late maturmg 
10-year-old is actually eight years old 
in development, but the educational 
system makes no allowance for maturi- 
ty lag. 

The sequence of developmental 
events is usually a few years later for 
males than females. Athletic -activity 
does to some degree accelerate the 
growth process, and the athletically- 
active adolescent will mature earlier 
than the one who is inactive. Good 
health and nutrition also influence 
early maturity, said Dr. Birbeck. 

The single most important function 
of the family today is to provide emo- 
tional security, but this is exactly what 
the family is not doing, said Dr. Sheila 
Thompson, psychologist and director 
of counseling, Douglas College, B. C. 

"Parents ought to love no matter 
what, but parental love is conditional," 
she said. She noted that parents "seem 
to be unhappy in their parenthood 
and are literally putting their kids out 
now by saying 'you do this or you leave" 
and we wonder why there are so many 
transients." 

Nurses can provide reassurance for 
adolescent epileptic patients and sup- 
port the parents who often react with 
fear, guilt, and resentment to their 
child's illness, said Dr. W.L. Auckland, 
clinical instructor, division of neurol- 
ogy, faculty of medicine, UBC. 

Nurses should maintain a matter- 
of-fact attitude toward epilepsy, he said. 
The school nurse should obtain a first- 
hand account of a seizure experienced 
at school and write it down immediate- 
ly. The teacher often needs reassurance 
from the nurse that the patient in sei- 
zure won't die or attack others." 

Dr. William S. Wood, clinical as- 
sistant professor, division of dermatol- 
ogy, faculty of medicine, UBC, said 
acne is one of the three most common 
diseases of the skin. 

And "no" — in answer to a nurse's 
question — Phisohex does nothing 
for the treatment of acne. Many pa- 
tients are treated without medication 
by washing frequently with as little 
soap as possible. Since heat activates 
the sebaceous glands, patients should 
avoid hot baths and steam baths. 

Serious injury resulting from an ac- 
cident can make a difference in the 



whole life pattern of the adolescent. 
Dr. G. Duncan McPherson, clinical 
instructor, division of orthopedics, 
faculty of medicine, UBC, said. 

Because of boys' preoccupation 
with sports, they are involved in five 
times as many accidents as girls, he 
said. The injured adolescent has a 
broken body image, often followed by 
a feeling of insecurity. Boys are more 
modest than girls, he said, and intimate 
nursing care can be disturbing to them. 

Management of diabetes requires 
a mature and sensible attitude, and 
since adolescents are not mature, man- 
agement of diabetes in such patients 
is more difficult, said Dr. John A. Hunt, 
internist at Lions Gate Hospital, North 
Vancouver. 

"The child must be controlled by 
parents who must be self-controlled," 
he said. The professional person needs 
to direct outside control from the par- 
ent to the child. "Parents need help 
and support in taking on a scientific 
responsibility," said Dr. Hunt. 

He noted adolescents sometimes 
give themselves too little or too much 
insulin, and that those who reject 
diabetic management require psychi- 
atric help. 

The course was planned for nurses 
working with adolescents in health 
care settings. Ruth Elliott, instructor 
at the school of nursing, UBC, was 
chairman of the course committee. 

OHA Speaker Says 
Traditions Will Change 

Toronto, Ont. — We cannot be niggar- 
dly about the cost of health services, 
according to A. Isobel MacLeod, direc- 
tor of nursing service at The Montreal 
General Hospital. "Concern for cost is 
justified," she said, "and costs must be 
controlled. But we have to pay what it 
costs to provide good care." 

Mrs. MacLeod addressed a nursing 
session at the annual convention of the 
Ontario Hospital Association in Toron- 
to, October 26-28. "Nursing is tradi- 
tional — yes or no?" was the topic at the 
session, and Mrs. MacLeod's address 
was concerned mainly with future 
changes in these traditions. 

Among her suggestions for control- 
ling costs in nursing was the justifica- 
tion of the number of nurses employed 
in each unit, suggesting that often a full 
staff of nurses is kept on duty when 
fewer are needed. Better use of time is 
another answer to the problem, and she 
suggested that a definition of the nurses' 
role would help define priorities 
"Then," she said, "it will be relatively 
easy to find time to do those important 
things which now are not done." 

Mrs. MacLeod also foresaw changes 

in the future role of nurses because of 

changing governmental attitudes toward 

health services. "The emphasis now is 

JANUARY 1971 



on disease prevention and health pro- 
motion, rather than on miracle cures. 
This means that in future nurses will 
not be segregated in their roles as public 
health nurses and hospital nurses. Both 
categories of nurse will be nursing the 
whole patient, with a view to total pa- 
tient care." 

Mrs. MacLeod said that in future 
nurses could take over some fields, such 
as the management of chronic illness 
and the continuity of the care of the 
family through good health. She suggest- 
ed that university schools of nursing 
immediately alter their programs to 
help bridge the gap between nurses and 
doctors, and convince the doctors that 
another category of health worker is 
unnecessary. "We must show the doctors 
what we can do to prove another cate- 
gory is not needed. And we must make 
patient care as prestigious and finan- 
cially worthwhile as education or ad- 
ministration." 

Dean Sane, administrator of North 
York General Hospital and a member 
of the five-man reaction panel, em- 
phasized that the type of nursing care 
given was to a large extent dependent 
on the doctors and other departments 
of the institutions. He warned nurses 
that governments — now involved in 
medical insurance schemes — and the 
consumer are demanding value for their 
money, and that nurses will have to do 
their part to provide it. 

The session was chaired by Dorothy 
Morgan, past chairman of the nursing 
administration section of the OHA. 
Other members of the reaction panel 
were Anne Chambers, staff nurse at the 
Wellesley Hospital, Toronto; Rose- 
mary Forbes, head nurse of the emer- 
gency department, Victoria Hospital, 
London; Adeline Jack, director of nurs- 
ing service, North York General Hos- 
pital; and Jack Campbell, a former 
patient at the York General. 

Three TV Programs 
Tell Nurses' Role 

Winnipeg, Man. — The place of the 
registered nurse in the nursing com- 
munity was outlined by Margaret Nu- 
gent, president of the Manitoba Asso- 
ciation of Registered Nurses, and 
Bente Cunnings, executive director, on 
a Winnipeg TV show. 

First in a series of three programs 
dealing with nursing care provided in 
the province, the show dealt with the 
relationship of the registered nurse to 
the licensed practical nurse in provid- 
ing care for patients. 

The two other programs will discuss 
the role of the psychiatric nurse and 
the role of the licensed practical nurse. 
Representatives of each association will 
be present to answer viewers' questions 
during a "phone-in" portion of the 
show. 

JANUARY 1971 



AORN Members Fly 
To Italy On Seminar 

Denver, Colo. — The Association of 
Operating Room Nurses held its first 
overseas seminar in Italy with 300 
members making the October trip. 

The discussion of operating room 
techniques was held jointly with 
AORN's Italian counter parts and in- 
cluded visits to hospitals, lectures, and 
seminars in Florence and Rome. 

Mrs. Caroline Rogers. AORN mem- 
bership coordinator who arranged the 
trip, said the sessions in Florence were 
planned around "disaster nursing" 
based on the floods in Florence in 
1964. 

Because of the "outstanding success" 
of this year's trip, Mrs. Rogers said the 
AORN is planning a second overseas 
seminar for 1971 to be held in Spain 
and Portugal. 

AORN is an international scientific 
and educational organization with a 
membership of 13,000 — who like to 
travel! 



RNAO Accepts Concept 
Of Group Bargaining 

Toronto, Ont. — 1 he concept of group 
bargaining, originally proposed by the 
Ontario Hospital Association, is ac- 
ceptable to the Registered Nurses' 
Association of Ontario. However, 
RNAO said group bargaining is pre- 
mature for 1971. 

Group bargaining means that a neg- 
otiating committee might bargain with 
nurses employed by a group of hospi- 
tals in the same area, such as Toronto, 
or with a group working in the same 
economic area, such as Sudbury, Sault 
Ste. Marie, and North Bay. Until now 
nurses in Ontario have bargained with 
the management of the hospital hiring 
them. 

Early last year the Ontario Hospital 
Association established a "master 
committee — joint bargaining for 
nurses." The committee is comjjosed 
of representatives of 17 hospitals 
engaged in collective bargaining with 
nurses. 

This committee and the RNAO 
held two meetings during the summer 
of 1 970. Following the meetings, RNAO 
staff and legal counsel reviewed pwlicy 
statements and the basic principles on 
which RNAO had engaged in collective 
bargaining. 

On September 24, 1970, RNAO met 
with several nurses' collective bar- 
gaining associations as a first step in 
formulating a proposal on group bar- 
gaining. At this meeting the approach 
by the "master committee — joint 
bargaining for nurses" was described 
and draft proposals developed by RNAO 
staff and legal counsel was discussed. 

At the request of the meeting, Anne 



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imend Vagisec Douche Liquid Concentrate 
jnf idence, for routine feminine hygiene, 
lansing, refreshing, deodorizing. 

1 help answer patients' questions, a new 
it "The Hows and Whys of Douching" is 
Die free of charge. Just mail this coupon 
jr supply. 


-a 

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Julius Schmid of Canada Ltd. 
32 Bermondsey Road, 
Toronto, Canada 374 


: Reconr 
• with cc 
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THE CANADIAN 

• 



NURSE 17 





For nursing 
convenience... 

patient ease 

TUCKS 

offer an aid to healing, 
an aid to comfort 

Soothing, cooling TUCKS provide 
greater patient comfort, greater 
nursing convenience. TUCKS mean no 
fuss, no mess, no preparation, no 
trundling the surgical cart. Ready- 
prepared TUCKS can be kept by the 
patient's bedside for immediate appli- 
cation whenever their soothing, healing 
properties are indicated. TUCKS allay 
the itch and pain of post-operative 
lesions, post-partum hemorrhoids, 
episiotomies, and many dermatological 
conditions. TUCKS save time. Promote 
healing. Offer soothing, cooling relief 
in both pre-and post-operative 
conditions. TUCKS are soft 
flannel pads soaked in witch hazel 
(50%) and glycerine (10%). 



TUCKS — the valuable nur- 
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comforter. 




w 



Specify the FULLER SHIELD® as a protective 
postsurgical dressing. Holds anal, perianal or 
pilonidal dressings comfortably in place with- 
out tape, prevents soiling of linen or cloth- 
ing. Ideal for hospital or ambulatory patients. 



WIN LEY- MORRIS l% 



TUCKS is a trademark of the Fuller Laboratories Inc. 
18 THE CANADIAN NURSE 



news 



Gribben, director of RNAO employ- 
ment relations, sent a letter to the secre- 
tary of the master committee. The 
letter stated: 1. that the concept of 
group bargaining is acceptable; 2. that 
representatives of nurses' associations 
of hospitals engaged in collective bar- 
gaining will enter into dialogue with 
RNAO to explore various approaches 
to group bargaining with the aim of 
developing proposals for discussion 
with the master committee; and, 3. that 
group bargaining is therefore pre- 
mature for 1971. 

At the Ontario Hospital Associa- 
tion's 46th annual meeting, October 
26-28, 1970, James Wilson, chairman 
of the master committee, said 17 of 
the 36 hospitals that have nurses' 
associations or are in the process of 
getting one, had approved the prin- 
ciple of joint bargaining. He said re- 
presentatives of hospitals had agreed 
that a master agreement would take 
care of big issues. 

The RNAO board of directors at 
its November 20-2 1 meeting discussed 
and confirmed Miss Gribben's letter 
to the master committee. 



Friesen Sponsors Two Awards 
To Be Given Annually By CHA 

Toronto, Ont. — Two annual awards, 
amounting to $2,500, have been pres- 
ented to the Canadian Hospital Asso- 
ciation by Gordon A. Friesen, pres- 
ident of Gordon A. Friesen Interna- 
t i o n a 1 Incorporated. Washington, 
D.C., an international hospital health 
care consulting firm. 

The executive committee of CHA 
approved and announced the following 
awards to be given annually at the Ca- 
nadian Hospital Association conven- 
tion; the Gordon A. Friesen Award of 
$ 1 ,500, to be given to the writer of the 
best article submitted to CHA on either 
hospital design, hospital planning, or 
hospital administration; a prize of 
$1,000 to the student who, on com- 
pletion of the two-year hospital organ- 
ization and management course, will 
most likely make a valuable contribi'- 
tion to the field of hospital adminis- 
tration. 'S' 




JANUARY 1971 



names 



The Registered Nurses' Association of 
Nova Scotia has announced two new 
appointments: 

Sister Clare Marie (R.N., St. Marthas 
Hospital School of Nursing. Antigonish, 
N.S.; B.Sc. St. Francis Xavier U., 
Antigonish; M.Sc.N.. Catholic U., 
Washington) as advisor in nursing 
education. Sister Clare Marie has 
taught basic sciences in schools of nurs- 
ing and has been director of nursing 
at St. Martha's Hospital, Antigonish, 
and St. Joseph's Hospital, Glace Bay. 
She has been both third and first vice- 
president of RNANS. 

Jean Maclean (R.N., Victoria Public 
H., Fredericton: B.N., McGill U., 

Montreal) as advisor in nursing ser- 
vice. Miss MacLean, during World 
War II, served in Canada, England 
and Northwest Europe with the Royal 
Canadian Army Medical Corps, and 
later in the militia as senior nursing 
officer for the Atlantic area. She held 
the position of director of staff educa- 
tion at Camp Hill Hospital, Halifax, 
and more recently was director of nurs- 
ing education at Victoria General Hos- 
pital, Halifax. Miss MacLean succeeds 
Marianne Fightlin. 

Muriel Violet Lowry (R.N.. The Mont- 
real General hospital School of Nurs- 
ing) died in Ottawa October 3, as a 
result of an accident. 

Miss Lowry was for 1 1 years super- 
visor of the first demonstration health 
unit established in the eastern united 
counties of Ontario in 1935. In 1946 
she became regional supervisor for 
Eastern Ontario for the Ontario De- 
partment of Health, with headquarters 
in Ottawa. Upon her retirement in 1 962, 
the Ontario Public Health Association 
conferred on Miss Lowry an honorary 
membershio. 

^■nHH^HB Rita Lussier (R.N., 
^^^^^^^^H Hdpital Maison- 
h^^^^^^^B neuve, Montreal; 
^BPVP^^H B. Sc. N., 
mf^ ^H Marguerite d'You- 

H| '^.Slk if^^H ville, Montreal; 
pi^ r^^H ^^-Sc-^- in admin- 

<[|.^^Ai^^H istration and edu- 
^^"^^^^B cation, Boston U.) 

•^^f ^B has been appointed 
to the position of program coordinator 
with the Association of Nurses of the 
Province of Quebec, effective January 
1, 1971. Prior to being analyst at the 
JANUARY 1971 





Helena Remier, upon her retirement as secretary-registrar of the Association 
of Nurses of the Province of Quebec, was honored at a reception at the Queen 
Elizabeth Hotel, Montreal, in conjunction with the association's November 
annual meeting. Hundreds of nurses and friends came to express their personal 
good wishes to Miss Reimer who, for 2 years, was the guiding hand of the 
ANPQ. Above, Miss Reimer receives a bouquet from her niece prior to being 
presented with an oil painting as a memento of her contribution. 



center for evaluation of positions in 
Quebec hospitals. Miss Lussier was co- 
ordinator of the nurses' station at the 
Man and His World Health pavilion at 
Expo '67, and secretary-registrar to the 
Montreal branch of the Association of 
Catholic Nurses of Canada. She was 
awarded a Canadian Nurses' FounHa- 
tion Scholarship in 1969. 

Nicole DuMouchel 

(R. N., Ste - Justine 
Hospital, Montreal; 
B. Sc. N., adminis- 
tration, InstitutMar- 
guerite d' Youville, 
Montreal; M.Sc.N., 
U . of Montreal) has 
been appointed Sec- 
retary-Registrar of 
the Association of Nurses of the Pro- 
vince of Quebec. Miss DuMouchel was 
previously a consultant with the Cana- 
dian Council on Hospital Accredita- 




tion. Having always been active in 
nurses' professional associations. Miss 
DuMouchel welcomes the challenge 
inherent in the position so ably filled 
by her predecessor, Helena Reimer. 

Alice ). Baumgart, associate professor, 
school ot nursing. University of British 
Columbia, and chairman of the com- 
mittee on nursing education of the 
Canadian Nurses' Association, is the 
first Canadian nurse to be awarded a 
Milbank Faculty Associate Fellowship. 
This three-year $15,000 associate 
fellowship will be used to advance 
Miss Baumgart's work in supporting 
Dr. George Szasz, director of the office 
of interprofessional education at the 
University of British Columbia, in 
encouraging the implementation of 
the team approach to health care. The 
team approach aims at teaching mem- 
bers of the various health professions 
to work together through interorofes- 

THE CANADIAN NURSE 19 



V 



a show of hands... 





^/" 



proves its smoothness 



NEW FORMULA ALCOJEL, with 
added lubricant and emollient, will 
not dry out the patient's skin — 
or yours! 

ALCOJEL is the economical, modern, 
jelly form of rubbing alcohol. When 
applied to the skin, its slow flow 
ensures that it will not run off, drip 
or evaporate. You have ample time 
to control and spread it. 

ALCOJEL cools by evaporation . . . 
cleans, disinfects and firms the skin. 

Your patients will enjoy the 
invigorating effect of a body rub with 
Alcojel . . . the topical tonic. 



^efresh\n9-<=°°''''&. 

ALCOJEL 

Send for a free sample 

through your hospital pharmacist. 




[Jellied 

RUBBING 

ALCOHOt 



WITH 
ADDED 

UJBRICANT«" 
EMOUIENT 





mv. 



BDH PHARMACEUTICALS 

Barclay Ave.. Toronto 550, Ontario 



names 



20 THE CANADIAN NURSE 



sional learning experiences to improve 
the quality of health care delivery and 
to reduce its cost. 

One of Miss Baumgart"s major efforts 
will be toward devising means by which 
the school of nursing can offer its 
expertise to other professional schools 
and faculties and can in return incor- 
porate the expertise of other professions 
into the training it gives to nurses. 

The Saskatchewan Registered Nurses" 
Association has awarded bursaries to 
three Saskatchewan nurses. Delia M. 
Howe (R.N., St. Paul's Hospital School 
of Nursing, Saskatoon; B.Sc.N., U. of 
Saskatchewan School of Nursing, Sas- 
katoon) $ 1 ,000 to assist her in complet- 
ing her M.A. degree at the Regina 
Campus. Mrs. Howe — currently on 
leave of absence as assistant director 
of the Regina Grey Nuns' Hospital 
School of Nursing — has been clinical 
instructor at Regina General Hospital 
School of Nursing and instructor in the 
centralized teaching program. 
Judith A. Lang (R.N., Regina General 
Hospital School of Nursing) $1,500 to 
assist in meeting requirements for a 
B.Sc.N. degree at Regina campus. Miss 
Lang has been on the teaching staff of 
the Regina General Hospital School of, 
Nursing, prior to which she worked in 
general duty at Victoria Hospital, Lon- 
don, Ontario and at the Fort Qu'Ap- 
pelle Indian Hospital. 
Kenneth B. Doepker (R.N., St. Eli- 
zabeth Hospital School of Nursing, 
Humboldt, Saskatchewan), $ 1 ,500 
to assist in study toward a B.Sc. N. 
degree at Saskatoon campus. Mr. Doep- 
ker has worked \n the public health 
field with the department of national 
health and welfare, has experience as 
general duty and operating room nurse 
at Wadena Union Hospital and Sas- 
katoon City Hospital. 

Adele Herwitz (R.N., Beth Israel H., 
Boston, Mass.; B.S. and M.A., Teachers 
College, Columbia U., New York) has 
been appointed executive director of 
the International Council of Nurses. 
She had previously agreed to a six 
months' tenure (The Canadian Nurse, 
June 1970), and on permanent appoint- 
ment in October stated "... I know 
that nurses joined together in a strong 
organization play a vital role in up- 
grading nursing standards and there- 
fore in improving health care .... I 
see very clearly the increasingly im- 
portant role ICN will play in the years 
ahead in helping nurses throughout 
the world to build and strengthen their 
national associations." i^ 

JANUARY 1971 



Personalized CAP-TOTE 



Your caps stay crisp, sharp and clean 
•rtien stored or carried in this clever 
carry-all. Clear, non-creasing flexible 
plastic bag with white trim, has zipper 
around top, carrying strap and hang 
loop. Squeezes flat for easy storage 
when not in use. Also great for wiglets, 
curlers or whatever. SVz' dia., 6' high. 
No. 333 Tote (no Initials] ... 2.50 ii. |»pd. 
SPECIAL! 6 or more totes, only 2.2S ca. 
INITIALS up to 3 gold enbfssid on tip . . . 
add .50 par Tote. 




vSmmmmm^ 



'J <. 




Personalized MINI-SCISSORS 

Tiny, useful, precision-made bandage 
scissors, only 3"^' long! Slip perfectly 
into uniform pocket or purse. Two year 
-^ guarantee included. Choose jewelers Gold 
Of gleaming Chrome plate finish. 

No. 1 236 Scissors (n initials) , . . 2.25 ei. ppd. 

SPECIAL! 1 itoz. scissors for just $20. ppd. 

ENGRAVING up to 3 initials, add .50 per scissor. 



tRS. R. F. JOHNSON 
SUPERV/S/ 



■dTJOHN WILLIAMS 
RESIDENT 



REEVES NAME PINS 

Largest-selling among nurses! Superb lifetime 
quality . , . smooth rounded edges . . . feather- 
weight, lies flat . . . deeply engraved, and lac- 
quered. Snow-white plastic will not yellow. Satis- 
faction guaranteed. GROUP DISCOUNTS. Choose 
lettering in Black, Blue, or White (No. 169 only). 

SAVE: Order 2 Identical 
Pins as precaution against 
loss, less changing. 



Personalized 



BANDAGE 
SHEARS 



6' professional precision shears, forged 
in steel. Guaranteed to stay sharp 2 years. 

No. 1000 Shears {no initials) 230 u. ppd. 

SPECIAL ! 1 Ooz. Shtars $24. total 

Initials (up to 3} ttched add 50c par pair 




W^ 



COHN.LPN. 





INaaMPIinly 

MF2Plis(saniaMl 



1 NaM Pia ealy 

2 Pill (saM aaaMi 



1.75 



2.60 



.85 



1.35 



2.05 



3.10 



1.15 



1.90 



am 
T 






All Metal CAP TAGS 

Fine selection of dainty, jewelry-quality Cap 
Tacs to hold cap bands securely. All sculptured 
metal, polished gold finish, with clutch fas- 
teners, approi. %" wide. Two Tacs per set, gift- 
boxed. Choose Initial Tacs RN, LPN, LVN . . . or 
Plain Caduceus . . . or RN Caduceus. Specify 
choice. 

No. CT-1 Initial Tacs ) 

No. CT-2 Plain CadiCtMS > ... 2.50 per sat, ppd. 

No. CT-3 RN Cadw«a$ } 
SPECIAL! 12 or iiort sits 2.00 pir stt ppd. 



Personalized 
CROSS PEN 

with 
Caduceus 




World famous Cross Writing 
Instrument with sculptured cadu- 
ceus emblem, full name engraved FREE 
on barrel (print name desired on LETTERING 
line in coupon). Refills available at any store. 
Cross Lifetime Guarantee. 

No. 3502 Chrome Finish SjOO ta. 

No. 6602 12KtGoldFillad...ll30oa. 




Nurses' White CAP CLIPS 

Hold caps firmly in place! Hard-to-find wfiite 

bobble pins, enamel on fine spring steel. Eight 

2" and eight 3" clips included in plastic snap 

box. 

No. 529 I 3 twxes for 1.75, G for 3.25. 

Clips \ 7 or more 49c par box. all ppd. 



Bzzz MEMO-TIMER 

We all forget! Time hot packs, sitz baths, 
heat lamps, even parking meters . . . remind 
yourself to check vital signs, give medica- 
tion, etc. Tiny (only \\i~ dia.). lightweight, 
sets to buzz at from 5 to SO minutes. White 
plastic case, black and silver dial. Key ring 
attached Swiss made. 
No. M-22 Timer . . . 3.98 ea. ppd. 
SPECIAL! 3 for 9.75.6 or more 3.00 ea. 





Deluxe POCKET-SAVER 

No more tired pockets! Sturdy pure white vinyl, 
with three compartments for pens, scissors, 
etc. Includes change pocket with snap closure 
for coffee money, and key chain. 4' wide. 

No. 791 t 6 for 2.9a 12 for AJBO. 

Pocket Saver \ 25 or mora 35c ea., all ppd. 



NIGHTINGALE LAMP 

An authentic, unique favor, gift or en- 
graved award) Ceramic ofT-white can- 
dleholder with genuine gold leaf trim. 
Recessed candle cup at front (candle 
not included). 7" long. 
No. F lOOS Lamp . . . 5.95 ea. ppd. 
SPECIAL! 12 or more, 3.95 ea. 
ENGRAVING up to 3 initials and 
date on satin gold plaque on top, add 1.00 par lamp. 





Trl-Coior BALL PEN 

Write in black, red and blue with one ball point pen. 

' tlie thumb changes point (and color). Steno fine 

nt (excellent for charts) Polished chrome finish. 

Nl.921 tall Ptn... 1. 50 11. ppd. 

SPUIU! 3 for 3.7S, 6 cr Hire 1.00 ••. ppd. 

No. 2924 Utitt letllls ... 50c u. ppd 



Caduceus CUFF LINKS 

Sim. Mother-of-Pearl set into gold finish link, 
spring arm Sculptured gold fin. caduceus with 
or without Rf^. Gift-boxed. 

No. 403900 LINKS (plain caduceus) { 3.95 pr. 
No. 403RN LINKS (R.N. Caducous) \ ppd. 




i^ 



sterling HORSESHOE KEY RING 

Clever, unusual design: one knob unscrews for in- 
serting keys. Fine sterling silver throughout, with 
sterling sculptured caduceus charm. 
No. 96 Key Ring 3.75 aa. ppd. 



EYEGLASS CADDY Pin 

Slip eyeglass bow into loop for safe, instant 

readiness . . avoid scratching, breakage. Sturdy 

pinback. safety catch. Gold or Silver plated. 

No.961Csdtfy...1.50M.pptf. 

No. 961 ST SttftiiTi Silver Caddy . . 3 N la. ppd 




NURSES CAP-TACS 

Remove and refasten cap band instantly 
for laundering and replacement! Tiny 
molded plastic tac. dainty caduceus 
Choose Black. Blue. White or Crystal 
with Gold Caduceus. or all black {plain) '>• 
No. 200 Set of 6 Tacs . . 1 .00 per sat 
SPECIAL ! 12 or more sets ... .ao per set 




Nurses ENAMELED PINS 

Beautifully sculptured status insignia: 2-color keyed, 
hard-fired enamel on gold plate. Dime-sized; pin-back. 
Specify RN. LPN, PN. LVN. NA. or RPh. on coupon. 
No. 205 Enameled Pin 1.50 aa. ppd. 



Set-Fix NURSE CAP BAND 

Black velvet band material. Self-ad- 
hesh'e: presses on, pulls off; no sewing 
or pinning. Reusable several times 
Each band 20' long, pre-cut to pop- 
ular widths: Vt' d' per plastic box), 
Vi' (8 per bOK), H" (6 per box), \' 
(6per box). Specify width desired in 
ITEM column on coupon. 




No, 6343 

Cap Band ... 1 box 1.50 
3 or more 1.25 ea. 



f 



Reeves AUTO MEDALLIONS 

Lend professional prestige Two colors baked enamel on 
gold background Resists weather fused Stud and 
Adapter provided Specify letters desired; RN. MO. DO, 
RPh. DDS. DMD or Hosp Staff 'Plain) 
No. 210 Auto Medallion 5.00 aa. ppd. 



Professional AUTO OECALS 

Your professional insignia on window decal. 
Tastefully designed m i colors. 4V4" dia. Easy 
to apply. Choose RN, LVN. LPN or Hosp. Staff. 
No. 621 Decal... 1.00 ea.. 

3 for 2.50, 6 or more .60 ea. 





Uniform POCKET PALS 

Protects against stains and wear. Pli^le white 
plastic with gold stamped caduceus. Two com- 
partments for pens, shears, etc. Ideal token gifts 
or favors. 

No. 210-E ( 6 for 1.50, 10 for 2.25 
Savers \ 25 or more .20 ea., all ppd. 



RN/Caduceus PIN GUARD 

Dainty Caduceus fine-chained to your professional 
letters, each with pinback. saf. catch. Wear as is 
or replace either with your Class Pin for safety 
GQ\i fin., gift-boxed Specify RN. LVN or LPN. 
No. 3240 Pin Guard 2.95 ppd, 




Personalized EXAMINING PENUGHT 

Deluxe model designed for Nurses, with caduceus 
imprinted on white barrel: aluminum band and 
pociiet clip. FREE initials hand-etched on band to 
prevent loss 5" long. US. made Batteries, bulb 
included (refiiacements any store) Plastic gift box. 
No. 007 Penlight 3.98 ea. ppd. 




^^ 



r' 



NURSES CHARMS 

Finest sculptured Fistier charms in Sterling or 
Gold Filled Ideal addition for bracelet or hang 
on pendant chain 

Choose No. 263 Caduceus, No, 164 Nurses 
Cap, No. 68 Graduation Hat or No. 8 Band- 
age Shears 2.75 ea. ppd. 

Specify Sltrtinf or 6J. oe^or COlOll oh coopoo. 




"Endura" Waterproof NURSES WATCH 

Swiss made, raised silver full numerals, lumin. mark- 
mgs fied-tipped sweep second hand, chrome stainless 
case Includes genuine black leather watch strap. 1 

year guarantee 

No. 1093 14.95 ea. ppd. 



Scripto PILL LIGHTER 

Famous Scripto Vu.Uehter with crysta|.clsar fuel 
Cli3nit)«r containms colorful airay of capsulK. pills 
and tablets Novel, unique, for yourself or for unusual 
gifts for frienrls. Guaranteed by Scripto 
No. SOO-P Pill LIltlMr 4.21 u. ppd. 



GROUP DISCOUNTS: 



25-99 pins, 5%; 100 or more, 10%. 

Send cash, m.0., or chock. No blllinKS or COO'S. 



Nurses' Personalized 

ANEROID 
SPHYGMOMANOMETER 

A superb scientific instrument espe- 
cially designed to fill the needs of 
today's busy, efficient nurses! Thways on the 
level with this hanger, 
whether my patient is 
lying, sitting, or walk- 
ing around. 



igm 



IBSC 



I'm clear-faced and 
easy to read. My white 
back makes my mark- 
ings stand out unique- 
ly, whether you look 
at my backbone scale, 
or tilt me diagonally 
to read small amounts 
with the corner cali- 
brations. 



mofi 



400 



I have the only shortie 
drainage tube around, 
and it's miles better 
than any other 
you've ever used. It's 
easier to handle, and it 
won't drag on the floor, 
even with the new low 
beds. So out goes one 
more path lo possible 
contamination. 



I'm the unique new CYSTOFLO" drainage bag, a 
true-blue friend to nurses, physicians and patients. 
Why don't we get acquainted? 



BAXTER LABORATORIES OF CANADA 



OIV'SiON Of TflAVtNOl lABOflATORlfS INC 

6405 Northam Drive Malton. Ontario 



REPORT 

to the 

Minister of National Health and Welfare 

on the 

Recommendations of the Task Forces 
on the Cost of Health Services in Canada 

from the 
Canadian Nurses' Association 

October 1970 



The Task Force Reports on the Cost of Health Services in Canada have been discussed 
in considerable detail. Most of the recommendations covering nursing or with nursing 
implications have been accepted; some with no comment because their intent was 
clear and conformed with the philosophy and objectives of the CNA. Only a very 
few of the recommendations were rejected, either because they were thought to be 
premature or certain aspects of the recommendations could not be supported because, 
in our opinion, they were not in the best interests of the public or members of the 
nursing profession. The details of our conclusions in respect to the recommendations 
studied are presented in Appendices I — VII. [Too extensive for inclusion in The 
Canadian Nurse] 

In the following pages we present some general impressions of this report and set 
down for your information what we consider the most urgent concerns of the organ- 
ized nursing profession. 

The suggestions to improve the operational efficiency of our present system of de- 
livering health care to the people of Canada are commendable, particularly in res- 
pect to the management and administration of hospitals for acute illness, but we are 
of the opinion that at best the changes suggested will make a relatively small saving 
in the cost of health care. It would seem that if there is to be any restraint in the in- 
crease of the cost of health services, certain fundamental changes must be made in 
our present system of delivery of health care. Some of these changes are indicated in 
the report but others, such as the rapidly increasing costs of personal medical care 
and the widely recognized gaps in medical services, have been given little considera- 
tion in the report. 



lANUARY 1971 THE CANADIAN NURSE 27 

% 



In respect to the changes suggested in our system of delivery 
of health services, we should like to see priority given to the 
recommendations dealing with the following aspects of 
reorganization: 

1 . The development of a complete health care system under 
one authority at the provincial government level, rather 
than thedistribution of services amongseveral departments 
or ministries. 

Recommendation (no number), volume I , page 13: 
"Administrative arrangements should be made to provide 
full coordination of the total health care delivery system 
at the provincial level, with health services, welfare serv- 
ices, mental health care, hospital care, and medical and 
ancillary care as elements of a single function and overall 
plan. Greater emphasis should be placed on defining the 
needs of elderly, low-income and other disadvantaged 
groups, and on evaluating the programs now directed at 
these groups, in order to achieve a judicious allocation of 
resources in relation to anticipated results." 

2. The organization of all health services in well-defined 
regions under the jurisdiction of a regional health board. 

Recommendation 1 , volume 2, pages 147-148: 
"That each province develop, at the earliest possible time, 
a comprehensive health system based on the coordination of 
planning, operation and financing through regional health 
boards which have the authority to provide organizational, 
management and consultative services to a broad spectrum 
of health care facilities in a prescribed area. The provincial 
authority would continue to maintain its overall control 
and coordinating functions, through a direct relationship 
with regional health boards." 

Recommendation 15, volume 2, page 152: 
"That the principle of progressive patient care within an in- 
dividual hospital, a hospital system and a health region be 
adopted as a basic requirement for the efficient operation of 
a regional health system." 

Recommendation 12, volume 2, pages 283-284 

(a) "That each provincial health planning body establish 
individual regional health planning boards within the 
province, as required, which would be responsible for the 
continuing planning, development and implementation 
of a regionalized, comprehensive, integrated and ba- 
lanced health care system of services and facilities 
within the context of the region's total spectrum of 
health services and coordinated with the planning of 
other community, regional, provincial, and national 
health and social agencies. 

(b) "That the regions be based on the health service market 
area to be serviced rather than on municipal, county or 
other defining boundaries withinaprovincialjurisdiction. 
There may be some regions which are interprovincial in 
scope and the provincial planning bodies involved should 
cooperate where health service market areas cross pro- 
vincial boundaries." 

28 THE CANADIAN NURSE 



(c) "That uniform regions be established in each province 
where feasible for those functions which relate to health 
in its broadest sense, including health related facilities 
which are usually the responsibility of other departments, 
e.g., homes for special care; that departments of Pro- 
vincial Government recognize and adopt the establish- 
ed regions for the purposes of planning, organizing, and 
implementing programs; and that voluntary agencies 
be encouraged to use the same uniform regions." 

(d) "That regional health planning boards be broadly rep- 
resentative of providers of health care, government 
and non-governmental agencies and other groups such 
as consumers who are concerned with health care." 

(e) "That regional boards be financed by Government and 
be responsible to the Provincial Government Body 
responsible for overall Provincial health planning as 
referred to in Recommendation 1 1 ."^ 

3. The inclusion of insurance coverage to all public institu- 
tions and agencies serving the health needs of a com- 
munity. 

Recommendation 9, volume 3, page 364: 

"That the patient who occupies other than an acute care 

bed should not be faced with an increased personal cost." 

Recommendation 10, volume 3, page 364: 
"That the alternatives to acute care provide an effective 
means of reducing or limiting the number of acute care 
beds required." 



4. Some more effective and less costly method of providing 
personal medical care. 

Recommendation 1 , volume 3, pages 21-22: 
"That a Committee on Personal Medical Services reporting 
and making recommendations to the regular conferences 
of the federal and provincial Ministers of Health through 
the Dominion Council of Health be established and con- 
tinue for at least five years to carry out the following func- 
tions: 

(a) continuing evaluation of the delivery of personal med- 
ical services and the recommending of indicated re- 
search and changes in the medical care delivery system 
or systems; 

(b) convening of an annual working conference on the 
delivery of personal medical care with participation 
by invited experts to exchange information, to discuss 
methods of research and to evaluate innovations, there- 
by providing a channel of communication between 
individual research workers across Canada and the 
Committee on Personal Medical Services; 

(c) evaluation of systems of delivery of medical care in other 
countries which might be relevant to the C a n a d i a n 
situation; 

(d) receiving and evaluating progress reports and final reports 

JANUARY 1971 



of all research activities related to the delivery of personal 
medical services which have been carried out by. or with 
financial support from, the Federal Government; and 
(e) the submission of reportsof the activitiesoftheCommittee 
on Personal Medical Services at least twice yearly." 



5. Greater emphasis, with financial support, placed on exper- 
imental and demonstration projects with the general 
objective of improving our system of meeting the health 
needs of a community. 



Recommendation 21 , volume 2, page 156: 
"That priority be given to the development of graduate educa- 
tional programsforclinical specialists in nursing, and forpost- 
basic specialty programs in clinical nursing." 

Recommendation 21 , volume 3, page 367: 
"That university educational programs in public health be 
strengthened through increased financial support to enable 
them to meet expanding needs." 

Recommendation 22, volume 3, page 367: 
"That there be more stress in these programs on training key 
members of the public health team together in joint classes 
and seminars." 

In respect to cost of hospital services, we feel that those 
recommendations dealing with integrated and shared fa- 
cilities under a regional plan and improved management 
of health agencies should be given priority. ^ Progress in 
these respects would lead to the patient being assigned to 
the most appropriate institution or agency for his care, be 
it on an in-patient or ambulatory basis. 

Some important aspects to be considered in bringing about 
improvement in the delivery of nursing service are: exami- 
nation of the structure of nursing service to ensure a work- 
ing environment which allows registered nurses to achieve 
their objectives in nursing care; the appointment of nurse 
administrators with a knowledge of current concepts in 
nursing practice as well as management skills; the availa- 
bility and use of consultant services. 

In the improvement of personal medical care urgent con- 
sideration should be given to assistance to physicians in 
institutional and office practice as well as in all types of 
ambulatory and home care. It is our conviction that there 
are sufficient assistants to the physicians at the present 
time, but these assistants need to be used to a greater ex- 
tent by the physicians. The Committee is of the opinion 
that the preparation and potential of the nurse is not being 
exploited to its full capacity. "The physician has permitted 
her greater technical responsibility in the care of patients 
recovering from major operations, and even greater tech- 
nical responsibility in the operating room. It is in relation 
to personal medical care that the physician has not ye' 
accepted the necessity of sharing and delegating some o 
his respionsibility to the nurse. "3 
lANUARY 1971 



The Committee believes that the majority of activities de- 
scribed for the physician's associate are either presently 
being carried out by the nurse or could be carried out by 
the nurse if she could utilize her present abilities to a greater 
extent and if capable, nurses were given more latitude to 
develop their skills.'' The extended role of the nurse could 
be realized in all health services and it is to be hoped that 
there will be demonstration projects to show this. 

The Committee firmly believes that there is an immediate 
need for experimentation with various patterns of delivery 
of health care, utilizing the nurse in an extended and more 
independent role. This, however, is only part of our think- 
ing in respect to priorities in experimenting with new 
departures in the system of providing health care. Experi- 
ments and demonstrations are needed in respect to regional- 
ization of the total health services, in the development of 
a wider variety of centers for ambulatory care and in the 
integration of treatment and preventive services. 

We recommend that the CNA give special support to the 
development of the following areas of research: 

1 . Task Force on Salaries and Wages 

Recommendation 7 , volume 2, page 150: 
"That the nursing components of health care be assessed and 
reorganized to provide for the better utilization of available 
personnel as follows: 

(a) by the adoption of current management organi- 
zation and techniques; 

(b) by the development of methods to improve the 
utilization of nursing personnel, based on care- 
fully formulated work standards and in-service 
education. In part, this could be accomplished 
by development in the in-patient care areas of 
the health care center of a system of identifying 
the specific nursing needs of each patient, and, 
therefore, the staffing pattern of each nursing 
unit. The development of nursing-team staffing 
patterns should be on a minimum base, rather 
than on a maximum patient<are basis, supple- 
mented by an adequate 'float' or 'flying squad' 
pool of full-time and/or part-time staff nurses; 

(c) by the development of methods of evaluating the 
quality of patient care; and 

(d) by the development of criteria for measuring 
productivity and evaluating performance of pro- 
fessional and technological personnel in the 
health field." 

Recommendation 10, volume 2, page 151: 
"That a national committee, composed of experts in nurs- 
ing, medicine, hospital administration and allied health 
fields, be established to develop a continuing operational 
.-itseai^phsDrogram to maintain progress in health care or- 
^ "ganization ^nd management techniques." 

tion 26, volume 2, page 157: 
nal committee composed of experts in nurs- 
THE CANADIAN NURSE 29 




ing, medicine, hospital administration and allied health 
fields, be established to: 

(a) devise methods for the development of standards 
for nursing care; 

(b) develop methods of evaluating the quality of 
patient care; 

(c) develop criteria for measuring productivity and 
evaluating performance of professional and 
technological personnel in the health field; and 

(d) establish a continuing operational research pro- 
gram to maintain progress in health care organ 
izational and management techniques." 



2. Task Force on Method of Delivery of Medical Care 

Recommendation 28, volume 3, page 63: 
"That promising proposals for more effective employ- 
ment of allied health personnel in the delivery of medical 
care be evaluated using well designed demonstration 
projects." 



References 

7 . Recommendation 1 1 , volume 2, page 283: 

"That administrative arrangements be established which 
will provide for full coordination of the total health care 
delivery system at the provincial and higher levels. This 
implies arrangements whereby the fields of health, wel- 
fare, mental health, hospital plan operation and medical 
care plan operation can be viewed as elements of a single 
function and health planning body. In one province, as 
an example, there are five agencies involved in these 
functions." 

2. Recommendation 20, volume 2, page 84: 

"That nursing service administrators should be prepared 
through educational programs and experience for the po- 
sition of management of the nursing service department." 
Recommendation 1 , volume 2, page 60: 
"That hospitals be encouraged to develop along lines of 
proven industrial organizational structure where lines of 
authority to an individual known as president or exec- 
utive vice-president for the day-to-day control of all 
operations are clearly defined." 
Recommendation 3a, volume 2 , page 1 1 : 
"That all hospital administrators be licensed and that 
this license be graded using education and experience 
as the main yardsticks. All hospitals should be graded as 
to the type of license its administrator requires." 
Recommendation 3b, volume 2, page II: 
"That this licensing program be the responsibility of a 
national body." 

Recommendation 28, volume 2, page 89: 
"That the objectives and functions of each department 
within the hospital should be clearly stated and each de- 
partment should be responsible for carrying out its func- 
tions." 

Recommendation 29, volume 2, page 89: 
"That the services supporting nursing be reorganized to 

30 THE CANADIAN NURSE 



increase efficiency in the delivery of nursing care to 
patients and so that the needed supplies and equipment, 
i.e., food, drugs, sterile supplies, linen, etc., are available 
at the time needed, in the place needed, and in the most 
usable form." 

Recommendation 1 1 , volume 2, page 151: 
"That all hospitals be encouraged to establish goals, ob- 
jectives and functional organizations through organized 
management programs, and that such programs include 
provision for the close, inter-departmental relationships 
required for effective operation." 

3. Hamilton, John D. Health Services Fifty Years Hence. 
Nursing Education in a Changing Society, ed. Mary Q. 
Innis. Toronto, University of Toronto Press, 1970, pp. 
193-208. 

4. Paragraph 1 , volume 3, page 62: 

"Some of the roles and tasks which now devolve upon 
physicians but which could be handled in whole or in 
part by practitioner-associates include: home visits, mid- 
wifery, well child care, considerable military medicine, 
triage, ambulance attendant service, emergency calls 
service, frontier and outpost coverage, some geriatric 
care, industrial medicine, periodic health examinations 
on well persons, administrative duties, dispensing, im- 
munization programs, operating room and clinical sur- 
gical assistance, some anesthetics, service in intensive 
care, recovery room and cardiac care units, health 
counselling, school health services, intern service in non- 
teaching hospitals, and the diagnosis and treatment of 
less complex or serious clinical problems generally." ^ 



The 

Canadian 
Nurse 

50 The Driveway, Ottawa 4, Canada 



& 

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JANUARY 1971 



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The Canadian Nurse 

OFFIOAL JOURNAL OF THE CANADIAN NURSES' ASSOCIATION 

THE CANADIAN NURSE 31 



Nursing — evolution 
or revolution? 



If nursing does not address itself to reality, it won't be around to plan for the 
future, the author warns. 



Loretta C. Ford, R.N., Ed.D. 




Whenever I talk with Canadians, I 
always ask them to remember that many 
of my assumptions are based on my 
own experience and education in the 
United States. It follows that occasional- 
ly I may not be addressing myself to 
issues that are pertinent to health in 
both our countries and our respective 
groups of nurses. However, I usually 
find that we have similar problems in 
health and in nursing. 

I have been a change agent of sorts, 
one who has been involved in a highly 
controversial (and often maligned) 
project directed toward expanding the 
role of nurses. Perhaps I am expected 
to debate the issue of whether or not 
nurses should assume expanded res- 
ponsibilities for care. If the year were 
1960, a debate would be appropriate. 
In 1960 we may have even debated 
whether or not change should be accom- 
plished by revolution or evolution. 
Today these debates are post ipso facto. 
Changes are being made — rapidly 
and without the usual evolutionary pace. 

My anxiety stems from my observa- 

Dr. Ford is Professor and Chairman, 
Community Health Nursing, University 
of Colorado School of Nursing, Denver, 
Colorado,^ U.S.A. This article was adapt- 
ed from a paper Dr. Ford presented at a 
forum sponsored by the University of 
Western Ontario's School of Nursing 
faculty on October 16, 1970. 



32 THE CANADIAN NURSE 



tion that nursing is moving at an evolu- 
tionary pace, while the world around us 
is exploding in revolutionary ways. 
Nursing needs to be in the forefront of 
the action, determining its own destiny 
as it seeks to fulfill its mission to care 
for people. Nursing must be responsive, 
flexible, timely, and timeless within 
the realities of the total mosaic of health 
and its present chaotic state. 

A quick review of this health care 
crisis is supplied by Dr. Ward Darley 
who said: 

"One has only to look back 25 years 
to appreciate the exponential rate with 
which change has taken place and, 
barring a world catastrophy, it is inevi- 
table that both the direction and speed 
of this change will continue. The com- 
ponents of this change, all of which are 
inevitables in themselves, constitute a 
chain reaction, the links of which arrange 
themselves in the following sequence: 
(1) increasing knowledge, (2) increasing 
specialism, (3) increasing demands for 
service, (4) increasing costs of service, 

(5) increasing shortages of personnel, 

(6) increasing complexity and efficiency 
in data processing and communication, 
and (7) increasing institutionalization 
(organization)." 1 

A less erudite wag blamed these phe- 
nomena on social trends. He sum- 
marized them with this alliteration: 
population, pollution, protest, protein, 
promiscuity, prices, pot, the pill, the 
JANUARY 1971 



Protestants, and the Pope. My suffixal 
approach is to summarize the problems 
as effluence, affluence, influence, and 
confluence. 

Our major problems stem from our 
myopic view of health. Reaching for 
high level wellness for all people through 
continuous, coordinated,comprehensive 
health care is an espoused goal. How- 
ever, to mount such a program, com- 
mitment and change in the systems that 
prepare practitioners and those that 
deliver health care will be required. 
How then shall we change? Just for the 
record and a quick reminder that nurs- 
ing has changed, listen to these rules 
for nurses that were uncovered recent- 
ly in a Denver Hospital. The date is 
1887: 

"In addition to caring for your 50 
patients, each bedside nurse will follow 
these regulations: 

1 . Daily sweep and mop the floors of 
your ward, dust furniture and win- 
dow sills. 

2. Maintain an even temperature by 
bringing in a scuttle of coal for the 
day's business. 

3. Light is important to observe the 
patient's condition. Therefore, each 
day fill kerosene lamps, clean chim- 
neys and trim wicks. Wash windows 
once a week. 

4. Nurses' notes are important to aiding 
a physician's work. Make your pens 
carefully. You may whittle nibs to 
your individual taste. 

5. Each nurse on day duty will report 
at 7 a.m. and leave at 8 p.m. except 
on the Sabbath on which day you 
will be off from 12 noon to 2 p.m. 

6. Graduate students in good standing 
with the director of nurses will be 
given an evening off a week for 
courting purposes or two evenings a 
week if you regularly go to church. 

7. Each nurse should lay aside from 
each pay day a goodly sum from her 
earnings for her benefits in her declin- 
ing years so she will not become a 
burden. For example — if you earn 
$30 a month, set aside $15. 

8. Any nurse who smokes, uses liquor 
JANUARY 1971 



in any form, gets her hair done in a 
beauty shop or frequents dance halls 
will give the director of nurses good 
reason to suspect her worth, inten- 
tions, and integrity. 
9. The nurse who performs her labors, 
serves her patients and doctors faith- 
fully and without fault for five years 
will be given an increase by the hos- 
pital administration of five cents a 
day providing there are no hospital 
debts that are outstanding." 

These rules indentify concepts of duty, 
reward, and destiny of another day. 
However, they are engrained in us from 
our traditions, our ideals, and our herit- 
age. In the past we emphasized duty as 
a basic value. Currently, reward and 
destiny gain much more of our attention 
in the here and now. 

But basic to these is the concept of 
duty: in the modern sense, it is com- 
mitment. Nurses talk glibly about 
their contribution and uniqueness in 
caring about and for people. In socio- 
logical terms of role theory, we as nurses 
claim our role to be an expressive one, 
while we assign to the physician an in- 
strumental role. 

The kind of role I am proposing for 
nurses is a blend of expressive and in- 
strumental components that can provide 
ways of meeting the "here and now" 
and the future needs of people, parti- 
cularly those people whose conditions 
are primarily non-pathological in nature 
and whose care requires non-medical or 
minimal medical supervision. 

To explain more fully this role, I 
will describe briefly the special project 
at the University of Colorado, the pe- 
diatric nurse practitioner program, 
designed to meet "here and now" 
child health needs and to influence the 
future of nursing. 
University of Colorado program 

The project was developed in 1965 
by representatives of the school of nurs- 
ing and the school of medicine, under 
the combined auspices of the two schools 
of the University of Colorado. ^'^ The 
purposes of the program were: 1 . to 



establish a new educational and train- 
ing program in pediatrics for profession- 
al nurses which will prepare them to 
assume an expanded role in child health 
as practitioners of nursing within the 
scope of the Colorado Professional 
Nurse Practice Act; and 2. to place the 
nurses who have received this new and 
augmented educational experience 
where they would have opportunities to 
practice their newly acquired skills in 
pediatrics in organized community 
health services, such as health stations, 
pediatricians' offices, and neighborhood 
health stations. 

Specifically, the project was con- 
ducted in two phases. Phase I was a four 
months educational experience for the 
nurse at the University of Colorado 
Medical Center. During this time as 
a graduate student in the school of 
nursing, she learned theory and prac- 
tice in pediatrics in clinically-oriented 
courses that included management of 
the well child, identification and care 
of acute and chronic conditions in 
childhood, and the care of the child in 
emergency situations. 

Under the direction of the pediatric 
and public health faculty members of 
the schools of nursing and medicine, 
project nurses focused on increasing 
their knowledge and skills in assessing 
the physical and psycho-social develop- 
ment of well children; studying varia- 
tions of growth patterns; learning to 
perform necessary developmental tests 
and evaluative procedures, such as his- 
tory taking, basic physical appraisal 
and some laboratory procedures; under- 
standing family dynamics; counseling 
parents in child rearing practices; and 
carrying out immunizations. 

Physical examination of children 
included the basic skills of inspection, 
auscultation, percussion and palpation, 
as well as the utilization of the otoscope 
and stethoscope. Through these tech- 
niques, nurses are capable of securing 
data, assessing their importance, and 
making wise decisions for nursing 
action. 

Management of the sick child was 
THE CANADIAN NURSE 33 



also part of the subject matter covered 
in Phase I. Project nurses learned to 
assess astutely the overall condition of 
the child in terms of the severity of the 
illness and the need for appropriate 
referral if medical care were indicated. 

Since project nurses were likely to 
be readily available in a particular 
neighborhood or locality and might be 
called on to function in various emer- 
gency situations, learning experiences 
in the care of childhood accidents, 
poisonings, and injuries are also includ- 
ed in the educational program. 

From October 1965 through June 
1969, 48 nurses entered our project. 
All had baccalaureate degrees; 13 had 
master's degrees. What were these nurses 
doing? Four were continuing in gradu- 
ate school; 25 were practicing in the 
Denver area health departments and 
pediatricians" offices; 8 were from out 
of state, practicing from Bolivia to 
Alaska, California to Massachusetts; 
3 were in teaching positions; 8 were 
temporarily retired to marriage. 

Our general findings indicated that 
the nurses were: 

1 . extremely competent to make the 
judgments required of them; 

2. delighted with their own role develop- 
ment because they felt competent 
and confident; 

3. highly acceptable to families, phys- 
icians, and many nursing colleagues; 

4. experiencing some difficulties when 
confronted with ancient patterns for 
the delivery of service, aging agency 
structures, and antiquated ideas of 
nursing supervision. 

Acceptance of this expanding role for 
nurses by families, physicians, and 
nurses is an interesting phenomenon to 
study. Our findings indicate that fami- 
lies were overwhelmingly accepting 
of this talented nurse. One nurse ob- 
served, ". . .patients seen regularly by 
the pediatric nurse practitioner (PNP) 
have a much lower failure rate for 
return well-child appointments: 9 per- 
cent in PNP clinics, against a range of 
25-40 percent failure rate in other 
clinics; field public health nurses re- 
34 THE CANADIAN NURSE 



ported mothers were following the 
advice given them by the PNP, and 
patients seen by the PNP had a far 
lower failure rate [compared] to the 
consultants" clinics, which were clinics 
established to screen children for speech, 
hearing, dental and nutrition defects 
conducted by allied health personnel.""'' 
A survey of parent attitudes toward 
the PNP was conducted by indigenous 
workers. They reported high acceptance 
of the PNP, making specific comments: 

1 . Mothers especially viewed counsel- 
ing concerning such child care prob- 
lems as feeding, toileting, growth 
and development as the responsi- 
bility of nurses and consequently 
felt more comfortable in bringing 
these problems to the nurse. 

2. Parents tended to feel that the PNP 
provided them with more specific 
and individualized health counsel- 
ing for their child than they had 
received from nurses not having 
this type of preparation. 

3. A physical assessment with the "lay- 
ing on of hands," so to speak, was 
considered by parents as an important 
aspect of well child management and 
increased their confidence in the 
health professionals" decision as to 
the "wellness'" of their child. ^ 

Assessment of PNP acceptance 

The Institute of Behavioral Science 
at the University of Colorado, under 
United States Public Health Service 
funding, studied the acceptance of the 
PNP role by professional nurses and 
physicians. Using Dr. Jay Jackson's 
Return Potential Model, a 64-item 
questionnaire was constructed from 
statements of prescriptions and pro- 
scriptions from content taught by the 
PNP faculty. Respondents were asked 
to indicate their level of approval or 
disapproval of certain independant 
acts of nurses. The following findings 
were reported: 

1. In general, doctors and nurses in the 
State of Colorado approve of the role 
of the Pediatric Nurse Practitioner . . . 



2. There are, nevertheless, differences 
among groups of doctors, groups of 
nurses, and doctors and nurses as well 
as among the different kinds of items 
on the questionnaire. . . 

3. Different kinds of nurses have different 
levels of approval-disapproval of the 
role. Nurses on teaching faculties at 
schools of nursing and public health 
nurses approve the role of the PNP 
more than do hospital nurses, office 
nurses, or school nurses. Among doctors, 
pediatricians who are associated with 
the faculty of the University of Colo- 
rado approve the role of the PNP more 
than pediatricians in private practice, 
general practitioners in private practice, 
or other physicians on the faculty at 
the Medical Center. There is more 
agreement among nurses than there is 
among physicians. 

4. The age of the respondent and the 
extent of his knowledge about the PNP 
program appear to affect the responses. 
With respect to age. the following 
generalization may be made, although 
samples are small in certain age groups; 
the younger the nurse, the more she 
approves the role; the older the nurse, 
the less she approves the role. Among 
the doctors, the situation appears to be 
reversed. The younger the doctor, the 
less he approves the role, the older the 
doctor, the more he approves the role. 
With respect to knowledge of the pro- 
gram, approval appears to be directly 
related to the amount of knowledge 
— the more informed the respondent 
reports himself to be, the higher is his 
approval of the role. 

There are four different ways of classifying 
the 64 items which appear on the question- 
naire. One classification deals with dif- 
ferent methods of characterizing independ- 
ence from the physician; the second deals 
with patient type; the third type deals 
with the traditional classification of in- 
strumental versus affective role perform- 
ance; and the fourth deals with the stage 
of treatment (pre-assessment, assessment, 
management, and follow-up). Within 
the independence item-class, most approv- 
al is given for independence from the 
JANUARY 1971 



physician on specific acts for which 
nurses might traditionally receive doctors' 
orders. By and large, the respondents 
approve the nurse's performance when it 
is most independent. 

Least approval is given for acts which 
involve judgment about patients' condi- 
tions. This suggests a tendency for re- 
spondents to prefer that at some point 
the nurse seek confirmation of her judg- 
ments. 

Patient Type 

Both respondents and faculty approve 
independence most for well child care 
and least for accident-injury cases. 

Instrumental- Affective Acts 
Independence is most approved for acts 
which are affective in nature and least 
for those which are instrumental as might 
be expected since the affective act is part 
of the traditional nursing role. 

Stage of Treatment 

Finally, acts which are classified in the 
follow-up category receive most approval 
at the independance end of the continuum. 
While assessment (basically diagnostic 
in function) items receive least approval, 
pre-assessment and management items fall 
in between. 

In general, the groups which express 
least approval, show low levels of agree- 
ment among themselves. This suggests 
that resistance to the role of the PNP is 
not well crystalized or solidified in the 
health professional population in Colo- 
rado.^ 

Another aspect of this evaluation 
was a study of a small sample of PNP 
students' ability to assess physically the 
condition of children in pre- and 
post-training test situations. 

Findings from video tapings and 
written reports were corroborated by 
students' verbal reports. Nurses, follow- 
ing their educational experience, in- 
creased the comprehensiveness and 
systematicity of their assessments. 

Students' self-perceptions were also 
studied. "Both before and after training 
the students failed to perceive that phy- 
lANUARY 1971 



sicians would be less approving of 
their role than would nurses."' This 
was probably due to the high approval 
of the physicians in general and the 
relatively low approval of some nurse 
faculty in the Medical Center. Students' 
confidence to perform the role is chang- 
ed significantly upward from prior to 
post-education experience. "Training 
not only affects the students' general 
attitude toward their qualifications, 
but also affects the intensity and the 
cohesiveness with which they hold 
these attitudes."^ 

This project was completed as a spe- 
cial demonstration in June 1969. Notice 
I said "special demonstration," because 
the melody lingers on. At the University 
of Colorado, the educational aspect 
(Phase I) is now conducted in our con- 
tinuing education services. Twenty-six 
nurses have been admitted since Sep- 
tember 1969 through October 1970. 
Nurses admitted to these courses have 
baccalaureate preparation in nursing, 
are required to make a statement of 
commitment to a clinical role, and, 
further, to submit a plan for adaptations 
in the health care system that will 
permit them to practice their expanded 
role. 

The prototype of the pediatric nurse 
practitioner was used to formulate a 
role for the school nurse practitioner 
initiated at the University of Colorado 
in the fall of 1970. Using the core-type 
approaches from the basic prototype, 
the school nurse practitioner will con- 
cern herself also with learning problems 
of school children. Sponsorship for 
this project, funded by the Burner 
Foundation, has evolved from the 
cooperative efforts of the schools of 
nursing and medicine at the Univer- 
sity of Colorado and the Denver public 
schools. 

Challenges AMA plan 

Providing for nursing leadership on 
the advanced level of nursing prepara- 
tion remains a crucial and pressing 
problem, especially as the idea of 
nurse practitioners is seen by some 



people as the answer to all the health 
manpower shortages! Other groups, 
among them the American Medical 
Association, have designs to use nurs- 
ing resources to solve their own man- 
power shortages. 

I challenge this effort vehemently. 
Practitioners such as those described 
are not physician's assistants. Physi- 
cian's assistants serve to contribute to 
the role of the doctor. Without the doc- 
tor, the physician's assistant cannot 
function. Tasks and functions perform- 
ed by the physician's assistant are dele- 
gated to him by the doctor. His account- 
ability is to the physician. 

A professional nurse who assumes an 
expanded role as practitioner is per- 
forming " . . .increasingly complex 
acts in health care based on a scientific 
background which permits increasing 
sophistication in her clinical judgment 
as advances in physical, biological and 
social sciences become medically signif- 
icant."^ The key words are professional 
nurse, scientific background, sophisti- 
cated clinical judgment, and advances 
in knowledge. 

Inherent in this role is a concept of 
foreseeability and accountability. The 
concept of forseeability is one in which 
the nurse practitioner has adequate 
scientific preparation to predict with a 
high degree of accuracy the outcome 
or consequences of her act.'° She there- 
fore can avoid harm and insure some 
measure of successful results. The 
concept of accountability is that the 
nurse must recognize and fulfill com- 
petently her responsibilities for the 
care of people. It involves taking risks 
at times, and nurses are not known for 
their adventurous risk-taking behavior. 

From my observations of public 
health nurses, their practice is often 
characterized by carefully constructed 
clandestine maneuvers to make the 
physician believe he is the Lord of 
Health. It is time all of us — nurses, 
physicians, social workers, and so on — 
stopped catermg to obsessive, compul- 
sive, neurotic behavior of our own 
and our colleagues who are so preoc- 
THE CANADIAN NURSE 35 



cupied building boundaries of profes- 
sional domains that we have forgotten 
our "raison d'etre.'^ 

Now ril deviate and address myself 
to a pertinent and current issue in nurs- 
ing in Canada. Via the grapevine, I 
understand you are hearing rumblings 
from the wise men in the east about 
making nurses into physician's assist- 
ants, particularly in the north country. 
Your reaction may be varied, but gener- 
ally I presume it is negativistic and 
hostile. I well recall similar feelings — 
my own and others — in the United 
States over the past six years. Let me 
point out, however, that you are get- 
ting a message. You may not like it, 
but, listen carefully before you blindly 
strike back. 

Giving advice is a waste of time. 
I'll avoid that. Instead, I'll share my 
experiences as a change agent who, in 
five short years — though it seemed 
like the millennium at the time — 
learned a great deal about nursing and 
its various individual and collective 
publics and problems. 

As I reflect on our experience with 
change, I have come to these conclu- 
sions: Basically we have been involved 
in the process of social change — chal- 
lenging territorialities, questioning the 
status quo, conditioning the public to 
expect more sophisticated and expert 
nursing care, shaking the foundations 
of unresponsive institutions in an effort 
to bring quality nursing care to people. 
It has not been easy, but it's never 
been boring. Now, of course, it's actual- 
ly fun. A quick summary of my exper- 
riences can be encapsulated in an allit- 
eration: communications, collegiality, 
change agents, and challenge. 

Communication 

Physicians and nurses speak different 
languages. Doctors say training, phys- 
ical examination, and medical, when 
they mean education, physical assess- 
ment or appraisal, and health. The 
latter, of course, is nursing's termino- 
logy. Semantic roulette is the name of 
the game. Nurses won't level with doc- 
36 THE CANADIAN NURSE 



tors and tell it "like it is." We are not 
interpreting trends and directions in 
nursing education or nursing service. 
We have been sneakily creating pro- 
fessionals who expect Dr. Rip Van 
Winkel to wake up and accept contem- 
porary nursing as he finds it — changed! 

Communicating by role models is a 
very effective eyeball-to-eyeball learn- 
ing experience. Nursing service must 
provide the opportunities, the climate, 
and the rewards. None of us should 
develop our role in isolation from the 
other, anymore than we should plan to 
change another's role without his par- 
ticipation. 

The biggest fiasco in communications 
recently was promulgated by the Ame- 
rican Medical Association's board of 
trustees, when it adopted a motion to 
utilize nurses for the expansion of 
medical service. Nursing's response 
was swift and hard-hitting. Deploring 
the unilateral action, the American 
Nurses' Association's president re- 
quested an opportunity to examine 
collaboratively the parameters of the 
respective physician and nurse roles. 
Now, months after the first shots were 
fired, constructive negotiations are un- 
derway. But if doctors and nurses en- 
joyed colleague relationships, this ex- 
plosion would never have occurred. 

Colleague relationships 

Few nurses in education or service 
experience true collaboration with 
physicians. Many physicians and 
nurses are educated at the same med- 
ical center and university campuses, 
but they hardly know each other as 
students. As faculty members in schools 
of nursing and medicine, we have not 
presented models of collaboration for 
our students. 

I contend that if students of nursing 
and medicine (and other disciplines) 
learn together, they'll earn together. 
They'll also be able to function effec- 
tively as team members. In my experi- 
ence, mutual respect and colleagueships 
are enriched as the nurse gains compe- 
tence, makes sophisticated clinical 



judgments, and is socialized in her 

role as a professional person. Part of 

that socialization is directed toward 
becoming a change agent. 

Change agents 

Assuming a new role is a hazardous 
task. Early in their preparation, our 
students at the University of Colorado 
experienced role reorientation jitters. 
Complete emersion in the theory and 
clinical aspects of the new role and 
faculty support proved effective in 
changing behavior. This was a relatively 
minor internal project problem compar- 
ed to the flak all of us received from 
others. Vicious abuse and the lack of 
trust of nursing colleagues were most 
difficult for me to tolerate. 

Our students experienced some of 
this, but their major problems were 
fitting into the health care system, carv- 
ing out and interpreting their existing 
personnel and programs to prevent 
overlapping, duplication, and fragmen- 
tation. Buddy assignments, empathetic 
and prepared supervisors, medical 
team support, and faculty confidence 
helped greatly in the early years. Today, 
agency structures and pediatric nurse 
practitioner models provide for the 
relatively smooth transition from stu- 
dent to practitioner. 

Nursing is now exploring with some 
degree of understanding and interest 
the potential of this expanded role. 
Two things are needed: 1 . the develop- 
ment of a climate in nursing that will 
permit and indeed encourage nurses to 
try our new ideas; and 2. statesmen who 
have the courage, vision, and stamina 
to influence nursing education and nurs- 
ing service to meet the nursing needs of 
society. If we don't soon assume our 
share of providing health care in our 
country, we'll price ourselves out of the 
market. 

Further, change agents must be select- 
ed with care. Maybe we should choose 
"change artists" — those who have a 
high degree of tolerance for ambiguity 
and can live fearlessly with uncertainty. 
Anyone who needs to have the world 
JANUARY 1971 



about him completely organized and 
structured every day should not try 
being a change agent. The risk is too 
great, the rewards too few and too far 
away. 

Still the challenge is before us. I 
believe we have demonstrated — in 
some measure — achievement of the 
goals nursing has espoused. You will 
recognize these as: a patient-side role, 
functioning at level of preparation; 
exclusion of non-nursing duties; auton- 
omous functioning; coUegiality ' with 
physicians; clinical nursing research 
opportunities; emphasis on wellness 
and prevention; and influence on the 
health care delivery system. 

Will the nurses in Canada read into 
the message "from the east" opportu- 
nity or threat? Will you creatively and 
constructively answer with a willingness 
to "assist the patient"? And if that helps 
the physician in some way, that's a great 
spin off! Think carefully about your 
answer. Recognize opportunity. Reduce 
threats. Renew your commitment to 
society, for here is where the future of 
nursing lies. 

Attack the bottlenecks 

Let us attack the bottlenecks in the 
health care delivery system. One cru- 
cial area is the entry point. Physicians 
have been the gate keepers, and the 
gates are stormed continuously by peo- 
ple demanding all different kinds of 
care, be they sick or well. Garfield 
suggests that a new delivery system 
which "... would separate the sick 
from the well. It would do this by 
establishing a new method of entry, the 
health testing service . . ." i' 

Regardless of the delivery service, 
nurses must be increasingly influen- 
tial in the entry, progression, and exit of 
people through the health care system, 
and should be investigating their roles 
as primary care takers. Further, they 
should be developing active collegial- 
ities with physicians and other health 
care workers. 

Unfortunately, in this area of con- 
cern for health care, the least respon- 
lANUARY 1971 



sive institution has been nursing edu- 
cation. Nursing educators have been 
relatively slow to provide leadership in 
trying out and trying on new roles. Our 
"head in the sand" search for the defi- 
nition of nursing will only result in our 
tails in the air, while the world flies by 
us. We have been reluctant to explore 
with physician colleagues our respective 
abilities to provide adequate opportuni- 
ties and continuing education to help 
practicing nurses assume expanded 
roles. 

We've given lip service to preparing 
clinical specialists in the graduate 
programs to be colleagues of the physi- 
cian. Yet, as Dilworth points out, the 
physician's influence and acceptance in 
the development of this role is a "potent 
variable"^^ in providing and rewarding 
role models in the health care system. 
More importantly, Dilworth asks who is 
to fill the gap between the medical care 
provided by the specialized physician 
and the inadequate attention give to 
people's total health needs. 

My posture is that nursing has a 
vital role to play in filling this gap. 
Coordinated, continuous, comprehen- 
sive health services will not be possible 
if the dynamic, humanistic component 
of nursing care is omitted. Nor will 
nursing fulfill its destiny or reap its 
rewards if it shirks its duty. Dilworth 
warns, "Nursing as a profession will 
either change by becoming more re- 
sponsive to the people's needs for 
health care or it will go the way of 
other species which have become ex- 
tinct because of inability to adapt to 
changing conditions."'-' 

The changing conditions today are 
revolutionary in nature. Traditions, 
values, and processes are challenged. 
Systems of education and service are 
experiencing chaos. But you will re- 
cognize the current chaos as opportunity, 
and make the most of it. The concepts 
of duty, reward, and destiny are well 
known to you. You will not shirk your 
duty. You will reap the rewards. You 
will carve out your destiny. But you'd 
be well advised to start whittling today, 



because your duty, your reward, your 
destiny, are here and now. 



References 

l.Darley. Ward. American medicine 
and the inevitables in its future. JAMA 
196:267-8. April 18, 1966. 

2. Bellaire. Judith. Paper presented at 
the Academy of Pediatrics 38th An- 
nual Meeting in Chicago on Oct. 23, 
1969. p. 6. 

3. Ihid.p.l. 

4. Silver, Henry K. and Ford. Loretta C. 
Physician's assistants; the pediatric 
nurse practitioner at Colorado. Aiiicr. 
J. Nurs. 67:1443-4. July 1967. 

5. Silver. Henry K., Ford. Loretta C. 
and Stearly. Susan. A program to in- 
crease health care for children: the 
pediatric nurse practitioner program. 
Pcclkitrics 3,9:156-60. May 1967. 

6. Hunter, Robert. "Notes on Findings," 
(preliminary report) on Pediatric 
Nurse Practitioner Project, fail 1969. 

7. Ihicl. p.8. 

8. IhiiL p.8. 

9. Murchison. Irene A. and Nichols. 
Thomas S. Unpublished definition. 

10. Murchison, Irene A. and Nichols, 

Thomas S. Le^al Fouiuhtions of 

Nursing Pnictke. New York. Mac- 

millan, 1970. 529 pages. 
1 I . Garfield. Sidney R. The delivery of 

medical care. 5</. Aiiicr. 222:4:15-23 

April 1970. 
12. Dilworth. Ava S. Joint preparation 

for clinical nurse specialists. Nitrs. 

Outlook 18:22-25, Sept. 1970. 
\i. Oi7.cii. p.22. ^ 



THE CANADIAN NURSE 37 



Congenital rubella — 
one approach to prevention 

Description of a program set up by one hospital to minimize the risks to 
personnel who come in contact with children excreting the rubella virus. 

Winifred M. Reid, B.Sc.N. 



Early in 1969 a boy was born in Burn- 
aby General Hospital to a woman who 
had contracted rubella early in her 
pregnancy. Mother and babe were dis- 
charged apparently healthy, but the 
baby was soon readmitted for investi- 
gation. The diagnosis was encephal- 
opathy and congenital rubella (rubella 
syndrome). Virology studies confirmed 
that the child was excreting rubella 
virus from his nasopharynx and urine. 

We were aware that rubella, contract- 
ed during the first trimester of pregnan- 
cy, could cause a number of anomalies 
in an infant. We had not, however, 
considered an infant who did not have 
symptoms of the disease as a potential 
source of infection.''^ 

But little Joe was a living fact, irref- 
utably the result of the "harmless" 
little virus, rubella. Then we thought 
of some of the other tiny patients we 
had cared for in the past — the blind; 
the mute; the retarded; those with bone, 
blood, and brain damage; and, the 
most common, those with cardiac 

Mrs. Reid, a graduate of the University of 
Alberta School of Nursing, is Director of 
Nursing at Burnaby General Hospital, 
Burnaby, British Columbia. This paper is 
adapted from an article she wrote for the 
June/July 1970 issue of RNABC News. 



38 THE CANADIAN NURSE 



lesions. Were they also excreting rubella 
virus while they were in hospital? 

The usual isolation precautions were 
taken while caring for Joe. He was in a 
separate room, and all those with whom 
he came in contact wore a gown and a 
mask. 

As rubella is highly contagious, most 
pediatric units make every effort not 
to admit these patients unless admission 
is absolutely necessary due to complica- 
tions. Although hospitals have a re- 
sponsibility for establishing policies 
and procedures for isolation cases 
and providing the necessary facilities 
and equipment, they cannot guarantee 
safety. Nurses have always been ex- 
posed to hazards that most hospitals 
do their utmost to minimize. 

We were most concerned about the 
young married women on our staff, 
particularly those working in the pedi- 
atric and obstetric areas. A good many 
healthy babies had been born to these 
nurses over the years, but not all were 
as fortunate. Although we recognized 
our responsibility to these nurses, we 
also believed each nurse had a re- 
sponsibility to protect herself from a 
variety of diseases and to consult her 
physician about both prevention and 
treatment of illness. 

How could we determine which 
JANUARY 1971 



nurses could safely be placed in these 
high risk areas? Fortunately, our pedi- 
atricians had done a good deal of re- 
search on this subject and guided our 
study of the literature. At the risk of 
oversimplifying our findings, the fol- 
lowing summary may be of interest. 

History and clinical manifestations 

Although rubella has been recognized 
as a clinical entity for more than 100 
years, it was not until Gregg reported 
congenital malformations following 
maternal rubella infection during the 
1940 Australian epidemic, that the full 
implications became apparent .3 

Over the next 20 years, many re- 
searchers attempted to assess the risk 
of congenital malformations following 
rubella in pregnancy. However, a study 
of disease during this period was dif- 
ficult, with no recourse to experiments 
using monkeys and human volunteers. 
The advent of the use of tissue culture 



in virology advanced the study of many 
diseases, such as poliomyelitis, and re- 
sulted in isolation of the rubella virus 
in 1962.^ 

Subsequent epidemics in Great Bri- 
tain in 1 962 and 1 963 and in the United 
States in 1964 and 1965, provided nu- 
merous cases for study. The United 
States epidemic resulted in one percent 
of the population contracting rubella, 
and between 10,000 and 20,000 infants 
born with congenital rubella malfor- 
mations.5 These children, now of school 
age, are a phenomenal cost to the tax- 
payers as they require specialized serv- 
ices. 

History has shown that rubella may 
be expected to reach epidemic propor- 
tions every six to nine years. Reports 
from many areas of the country today 
indicate a high incidence of the disease, 
which some authorities claim to be of 
epidemic proportions. 

Prior to 1964, the clinical features 




lANUARY 1971 



usually associated with rubella syn- 
drome were cataracts, cardiac defects, 
and deafness occurring singly or in 
combination. Following the 1964 
epidemic, however, a wide variety of 
signs and symptoms were recognized 
in addition to the classical symptoms. 
These included neonatal purpura, 
thrombocytopenia. hepatosplenome- 
galy, jaundice, bone lesions, pneumo- 
nitis, myocardial damage, and central 
nervous system involvement. 

Although embryopathy occurs more 
frequently in the first trimester of preg- 
nancy, a lower incidence has been re- 
ported during the second trimester and 
later. 

Dudgeon compiled data from several 
studies showing that rubella contracted 
3 to 4 weeks after the onset of the last 
menstrual period gave a 60 percent 
chance of anomalies in the infant; 5 to 
8 weeks, 35 percent chance; 9 to 12 
weeks, 15 percent; and 13 to 16 weeks, 
a 7 percent chance of defects.^ 

Subclinical infections in the mother 
may result in a baby with rubella anti- 
bodies but no clinical manifestations of 
disease at birth. As the baby can ex- 
crete the rubella virus for a year or 
two, an obvious hazard faces hospital 
personnel. 

Preventive measures 

Many women in early pregnancy 
come in contact with rubella despite all 
precautions. In these cases, gamma 
globulin has been used to prevent or 
diminish the severity of the disease. In 
rubella, the object is to prevent trans- 
mission of the disease to the fetus. 

Robert Green reports that gamma 
globulin does not protect against vir- 
emia, but rather reduces the occurrence 
of clinical rubella. He therefore suggests 
that its use be restricted to susceptible 
mothers who are exposed to rubella 
and in whom clinical evidence of the 
infection is not yet evident.' 

Therapeutic abortions are considere' 
THE CANADIAN NURSF 



by many abortion committees, provid- 
ed that disease is demonstrated by viral 
cultures in pregnant women* 

H.I. test 

A relatively simple method of deter- 
mining the immune status to rubella 
is the hemagglutination inhibition test 
(H.I.) presently done in provincial 
virology laboratories. 

Natural rubella infection usually in- 
curs lifetime immunity, and 85 percent 
of young adults have this natural im- 
munity. However, unless an antibody 
test is done, there is no way of identi- 
fying the 1 5 percent of nurses who are 
susceptible to the disease. 

In June of 1969, little Joe was still 
on our pediatric unit and continued to 
excrete rubella virus. Our staff and 
pediatricians were becoming more 
informed and concerned about the 
problem. The following steps were 
taken, which have since led to a pro- 
gram of H.l. testing in the hospital: 

1 . Discussion with the director of the 
hospital laboratory to determine the 
feasibility of and the program for 
drawing blood from female em- 
ployees. 

2. Discussion with the director of the 
provincial virology laboratory to re- 
quest that testing of staff proceed. 

3. Development of an "employee rubel- 
la antibody test" form to be complet- 
ed by the employee and left with the 
blood specimen in the laboratory. 

4. Discussion with department heads 
whose personnel are in contact with 
high risk areas, for example, physio- 
therapy, laboratory, radiology, diet- 
ary, and housekeeping. 

5. Initiation of the H.I. test for all exist- 
ing pediatric and obstetric staff. 

6. Initiation of routine preemployment 
testing of pediatric and obstetric 
staff and others who might wish to 
take the test. 

The H.I. testing program has been im- 
40 THE CANADIAN NURSE 



plemented in this hospital with min- 
imal problems. Although the number of 
persons tested to date is too small to be 
statistically reliable, our results show 
1 8 percent of those tested to be essen- 
tially negative, i.e., a titre of less than 
1:8. 

Employees with negative tests are 
advised to discuss this with their per- 
sonal physicians who receive a copy of 
the results. Although vaccine has not 
been readily available, we belie\e an 
employee should be aware of her im- 
mune status to rubella. It then becomes 
her responsibility to take appropriate 
action. We have offered to transfer to 
other hospital areas nurses with nega- 
tive H.I. results. 



Rubella vaccine 

A live attenuated rubella virus vac- 
cine is now available and being used by 
many provincial departments of health 
to control the impending rubella epi- 
demic. Litde as yet is known about the 
effect on the embryo if a woman is vac- 
cinated shortly beforeorduring pregnan- 
cy. However, as the ability of the atten- 
uated live virus to cross the placental 
barrier is known, the vaccine should 
be used in sexually active women of 
child-bearing age only if pregnancy 
can be excluded and the use of effec- 
tive contraceptives assured during the 
ensuing two to three months while 
antibodies are developing. 

Little Joe is now nearly two years 
old and still with us. Although he is no 
longer excreting rubella virus, we have 
been unable to find a foster home for 
him, which is necessary as his mother 
cannot cope with her other children 
and Joe. He is blind, spastic, and se- 
verely retarded, and yet a small spark of 
the essence of Joe comes through as 
a nurse familiar to him calls his name, 
and his eyes move to the direction of 
the voice. 



If, by our program at Burnaby Gen- 
eral Hospital, we can prevent one em- 
ployee from having a baby with congen- 
ital rubella, we will more than justify 
the existence of such a program. 

References 

1. Monif, G.R. et al. Postmortem isola- 
tion of rubella virus from three chil- 
dren with rubella-syndrome defects. 
Uincet 1:723-4, Apr. 3, 1965. 

2. Bayer, W.L. et al. Purpura in congen- 
ital and acquired rubella. New Eng. J. 
Med. 273:1362-6, Dec. 16, 1965. 

3. Gregg, N.M. Congenital cataract follow- 
ing German measles in mother (1941). 
Trans. OtUhal. Soc. Aii.st. 3:35-46. 1942. 

4. Dudgeon, J. A. Maternal rubella and 
its effect on the foetus. Arch. Dis. Child. 
42:110-25. April 1967. 

5. Ibid. 

6. Ibid. 

1. Green. R.H. end. Studies of the natural 

history and prevention of rubella. 

Amer. J. Dis. Child. 110:348-65, Oct. 

1965. 
8. Douglas, G.W. Rubella in pregnancy. 

Amer. J. Niirs. 66:2665-6, Dec. 1966. 

Bibliography 

Douglas, Gordon W. Rubella in pregnancy. 

Amer. J. Niirs., 66:2664-66, Dec. 

1966. 
Drug and Therapeutic Information inc.. 

The Medical Letter. 1 1:89-92. Oct. 31, 

1969. 
Kettyls. G.D. Test for rubella. B.C. 

Medical Journal. 11:373, Nov. 1969. 
Krugman, Saul. Rubella — new light on 

an old disease. Amer. J. Niirs.. 65:126- 

127, Oct, 1965 
Congenital rubella syndrome. B.C. Medi- 

calJoiirnal 11:291, Sept. 1969. 
Vince, Dennis J. Prevention of rubella 

embryopathy. CMAJ 100:777-8, April, 

1969. ^ 



JANUARY 1971 



Selection and success of students 
In a hospital school of nursing 



The authors suggest that the use of pre-entrance selection tests for nursing 
candidates can lead to better selection procedures and possibly fewer dropouts. 



Elizabeth A. Willett, Ph.D.; Reverend Pius A. 
Riffel, S.)., Ph.D.; Lawrence J. Breen, Ph.D.; 
and Sister Elinor J. Dickson, C.S.|., B.A. 



Screening procedures that utilize gen- 
eral and specialized tests of vocational 
and educational aptitudes have been 
incorporated into the selection pro- 
grams of professional nursing training 
institutions in the United States over 
the past four decades.' Although not as 
widespread in Canada, screening pro- 
cedures that make use of standardized 
tests are being used indirectly by the 
admissions committees of some hos- 
pital schools. St. Michael's School of 
Nursing in Toronto, through the coop- 
eration of the hospital's psychological 
services, has made use of a relatively 
comprehensive battery of standardized 
tests since 1964 as part of its pre-en- 
trance selection process. 

Reasons for testing 

The reasons usually given for the 
use of such tests have been summarized 
by Dent and include the following: 
First, the admission of students who 
later withdraw involves a financial loss. 
Second, the morale of some students or 
of an entire class may be affected by 
the admission (and later withdrawal) 
of students who encounter considerable 
difficulty with the program. Third, the 
quality of instruction can be seriously 
affected. Fourth, some highly qualified 
candidates, especially should they apply 
late, may be rejected because of the 
acceptance of less qualified candidates. 
Last, but certainly not of least impor- 
lANUARY 1971 



tance, lack of success may seriously 
affect the psychological growth and 
development of those less qualified 
candidates who are later forced to with- 
draw.^ 

Scope of present research 

To determine the predictive value 
of the tests used in the St. Michael's 
Psychological Services Nursing Candi- 
date Selection Battery, the present re- 
search project was established. Specif- 
ical.ly it had as its objective the evalu- 
ation of the effect(s) of the pre-entrance 
testing program on students selected 
for the 1967. 1968, and 1969 graduat- 
ing years. 

It was with predictability that the 
present study was primarily concerned. 

Both Dr. Willett and Dr. Riffel have held 
the position of consultant to St. Michael's 
School of Nursing. Dr. Willett is now 
Assistant Professor of Psychology at Sag- 
inaw Valley College. Michigan. Dr. Riffel. 
who is Associate. Department of Psychia- 
try. University of Toronto and Adjunct 
Professor, Department of Psychology. 
University of Windsor, retains the posi- 
tion of Director of St. Michael's Hospital 
Department of Psychology. Dr. Breen 
is now Assistant Professor of Psychology 
at the University of Manitoba. Sister 
Elinor Dickson, now at the University of 
Ottawa, is working toward a master of 
arts degree in psychology. 



but not in a singular way. Rather it was 
an investigation that attempted to as- 
sess: l.the efficacy of pre-entrance 
screening procedures in nursing candi- 
date selection; 2. the predictability of 
specific psychometric instruments in 
relation to success during the three- 
year period as well as on the Register- 
ed Nurses' Association of Ontario (RN) 
examinations; and 3. the factors that 
differentiate successful candidates 
(»lass) from those who withdrew from 
t\\ program (dropouts), accepted can- 
didates who did not come into the pro- 
gram. (ADNC), and those candidates 
who were rejected (rejects). 

Description of tests used 

Although the battery of tests used 
by St. Michael's Hospital psycholog- 
ical services in screening nursing can- 
didates has been modified from time 
to time, basic instruments such as the 
College Qualification Tests (CQT), 
F'orer Structured Sentence Completion 
Test (FSSCT) and the GeneraJJnfor- 
mation Questionnaire (GIQ) were 
used for the 1967, 1968, and 1969 
graduating classes — those classes for 
which pre-entrance assessment data 

Copies of the full research report are 
available on request to Sister Marion Bar- 
ron, C.S.J., Reg.N., B.Sc.N.. M.Ed., Dir- 
ector, St. Michael's School of Nursing, 
35 Shuter St.. Toronto 25."!. Ontario. 

THE CANADIAN NURSE 41 



were analyzed in the present investi- 
gation. 

The CQT is a series of scholastic 
ability tests developed by Bennett, 
Bennett, Wallace, and Wesman for use 
by colleges and other post-secondary 
educational institutions in admission, 
placement, and guidance procedures.^ 
The three tests involved in the series 
yield six scores: Verbal; Numerical; 
Information, from which score can be 
derived two separate scores for Science 
and Social Science; and Total. The 
Verbal test consists of 75 vocabulary 
items; 50 of these require identifica- 
tion of synonyms, and 25, identifi- 
cation of antonyms. The Numerical 
test contains 50 items drawn from 
arithmetic, algebra, and geometry. The 
Information test is composed of 75 
items, half of which deal with the na- 
tural sciences (physics, chemistry, and 
biology), the other half with social 
studies (history, government, econ- 
omics, and geography). 

Verbal and numerical tests have a 
long history of success in predicting 
academic achievement. Research has 
shown vocabulary to be one of the most 
efficient measures of verbal ability. 
Although not effective in as many areas 
as tests of verbal ability, those tapping 
numerical ability have also been usefyl 
predictors "even in fields which do not 
obviously require numerical ability.'' 

The inclusion of the Information 
subtests of the CQT (Science and So- 
cial Science) in the St. Michael's Hos- 
pital Psychological Services Nursing 
Candidate Selection Battery represents 
the widely held belief that a measure 
of the educational background a stu- 
dent brings to any institution of higher 
learning will be indicative of his or her 
future academic success. Although the 
! student's high school record is a retlec- 
\tion of her formal educational history, 
and may he a good predictor of later 
academic success, there are serious 
limitations attendant to its exclusive 
use. 

Bennett et al have summarized the 
major difficulties inherent in placing 
any critical reliance on high school 
records: 

"Grading standards vary from one 
42 THE CANADIAN NURSE 



high school to another so that grades 
may not be at all comparable. Students 
may take courses quite different in 
inherent difficulty, one student earn- 
ing A's in easy courses while another 
earns B"s in more challenging subjects. 
Informal education, the learning which 
takes place outside the school setting, 
is only accidentally reflected in high 
school grades."^ 

The inclusion of the Information 
subtests, originally prepared to pro- 
vide a uniform survey of the student's 
academic knowledge, served as an in- 
dicator of the breadth of information 
she had previously acquired, and on 
which she would be expected to build 
in the future. 

In addition to providing a predictive 
tool as well as uniform information 
about candidates" academic background, 
the use of the CQT allowed for compar- 
isons between St. Michael's Hospital 
School's candidates and those college 
freshmen entering a university program 
leading to a degree in nursing. Such 
comparisons were possible as the 
24,000 students from 37 colleges and 
universities in 22 states on whom the 
tests were originally standardized, 
were grouped from all schools accord- 
ing to degree sought. 

Another psychometric tool that has 
always been a part of St. Michael's Hos- 
pital Psychological Services Nursing 
Candidate Screening Battery is the 
Forer Structured Sentence Comple- 
tion Test (FSSCT). The FSSCT can 
best be described as a projective tech- 
nique that allows for indirect assess- 
ment of the candidate's personality 
dynamics. 

Forer structured his sentence stems 
to elicit responses (completions) re- 
flecting the subject's reactions to inter- 
personal figures (mother, females, fa- 
ther, males, groups, authority); wishes; 
causes of own aggression, anx- 
iety and fear, depression, failure, and 
guilt; reactions to aggression, rejec- 
tion, failure, responsibility, and school. 
Forer states, "... the use of highly 
structured items allows for wide cover- 
age of the attitude-value system and 
points up evasiveness, individual dif- 
ferences, and defense mechanisms."^ 



One of the major advantages of a 
technique such as the FSSCT is that 
it is indirect in its approach to per- 
sonality assessment. Distortion of 
personality due to the subject's own ' 
"halo" effect is largely precluded when 
projectives are employed. Unfortunate- 
ly, the major disadvantage of tests such 
as the FSSCT, also stemming from its 
indirect, qualitative approach, is that 
the completions do not lend themselves 
well to quantification for purposes of 
research. Although some research in-, 
roads have been made into the use of 
sentence completion tests, they still 
present the problems which obtain 
when data has to be coded on a subjec- 
tive, judgmental basis. 

Also subject to difficulties inher- 
ent in projective techniques, such as 
the FSSCT, is the General Information 
Questionnaire (GIQ). The GIQ was 
originally developed at St. Vincent's 
School of Nursing in New York, and 
later copyrighted by Coville.'' The 
responses to this questionnaire were 
used directly by both Psychological 
Services and St. Michael's School of 
Nursing admissions committee in 
screening candidates. Included in the 
GIQ are 27 self-rating scales that re- 
flect the subject's level of self-confi- 
dence, ability to make decisions, cour- 
tesy, tact, ambition, and so on. 

Additional screening instruments 

In addition to the GIQ, FSSCT, and 
CQT, other instruments used at St. 
Michael's include the Raven's Pro- 
gressive Matrices (Ravens), Minnesota 
Multiphasic Personality Inventory 
(MMPI), and the Sixteen Personality 
Factor Questionnaire (16PF). The 
Ravens assesses an individual's cap- 
acity to apprehend meaningless figures, 
see the relations between them, con- 
ceive the nature of the figure com- 
pleting each system of relations pre- 
sented, and, by so doing, develop a 
systematic method of reasoning.^ Thus, 
in broad terms, the Ravens can be con- 
sidered a test of intelligence. 

The MMPI, a test for assessing per- 
sonality functioning, was devised by 
Hathaway and McKinley partly to 
"... lessen the conflict between the 
JANUARY 1971 



psychiatrist's conception of the ab- 
normal personality and that of psy- 
chologists . . . who must deal with ab- 
normality among more nearly normal 
persons," and partly "in the hope that 
it might be nearly universal in both its 
interpretation and its applicability to 
individual cases. "^ The MMPI allows 
for the assessment of personality char- 
jacteristics on the basis of scores on 
jthe following nine clinical scales: 
I hypochondriasis, depression, hysteria, 
psychopathic personality, masculinity- 
femininity characteristics, paranoia, 
psychasthenia, schizophrenia, and 
hypomania. Other MMPI scales that 
are useful in personality assessment 
include the lie (L) score, validity (F) 
score, and a measure of social iso- 
lation (Si). 

The MMPI, used as a post-entrance 
test, was administered to all appli- 
cants accepted into the 1967 gradua- 
ting year at St. Michael's. In the 
present study it was used to assess the 
personality differences between the 
class and dropouts. 

Another instrument devised by more 
basic research in psychology to give 
the most complete coverage of person- 
ality possible in a brief time is the 
16PF. Cattell and Eber report, "The 
personality factors measured are not 
just peculiar to the 16PF Test. They 
have been established as unitary, psy- 
chologically-meaningful entities in 
many researches in various life situa- 
tions."^" It is this very meaningfulness 
that makes the 16PF an attractive 
instrument for use as a screening device. 
The 16PF assesses personality along 
the following dimensions: Reserve, 
Intelligence, Emotional Stability, Hu- 
mility, Prudence, Expediency, Res- 
traint, Self-reliance, Trust, Practicality, 
Forthrightness, Confidence, Conser- 
vatism, Dependency, Control, and 
Tension. 

Although the literature is replete 
with studies assessing the success of 
selection procedures used in nursing 
schools, none of them have used bat- 
teries identical with those employed by 
St. Michael's Hospital psychological 
services. Thus, it seemed logical that 
St. Michael batteries be studied to de- 

lANUARY 1971 



termine the effectiveness of the speci- 
fic tests used in each battery and their 
differential predictability. Success in 
nursing, for the purposes of the present 
research project, was operationally 
defined in terms of the candidate's 
academic and/or clinical performance 
during her three-year training period 
as well as in terms of her RN examin- 
ation results. 

Statistical procedures 

All scores for candidates in their 
respective year were subjected to cor- 
relational analyses to determine which 
of the screening devices provided scores 
that were valid predictors of success 
in the nursing program, that is, showed 
significant correlations with academic 
and/or clinical marks and RN examin- 
ations results. To determine the psy- 
chological differences between accept- 
ed candidates (class), accepted appli- 
cants who did not enter the school 



(ADNC), rejects and dropouts, indi- 
vidual analyses of variance of each of 
the psychological variables were also 
carried out. All analyses were handled 
by an IBM 360/60 computer. 

Intellectual ability test results 

Correlations between CQT scores 
and RN examination results that reach- 
ed statistical significance (p = 0.05) 
are presented in Table /.In terms of 
the magnitude of the correlations as 
well as their number, the CQT Total 
score appeared to be the best predictor 
of success in nursing as measured by 
the RN examinations. Although not 
consistent predictors across the three 
years, the Verbal and Science scores 
also showed significant correlations 
with RN examination results. 

As far as correlations between CQT 
scores and school marks were concern- 
ed, it was also the CQT Total that 
showed the greatest number of cor- 



TABLE 1 

Significant Correlations Between CQT 
Scores and RN Examination Results 









Social 






CQT Scores 


Numerical 


Verbal Science 


Science 


Total 


RN Examinations 












1967; N = 58 












Medical Nursing 








.31 


.37 


Surgical Nursing 




.25 




.24 


.37 


Obstetric Nursing 




.32 




.32 


.38 


Pediatric Nursing 




.28 




.39 


.45 


Correlation (r) = .21 


,p<.05; r = 


= .30, p < .01 ; r = .40 


p < .001 




1968; N = 83 












Medical Nursing 




.20 


.25 


.29 


.35 


Surgical Nursing 












Obstetric Nursing 






.25 




.22 


Pediatric Nursing 




.25 


.22 .18 




.31 


r=.18, p <.05;r = 


.26, 


p<.01; 


r = .36, p < .001 






1969; N = 84 












Medical Nursing 






.33 


.28 


.29 


Surgical Nursing 






.30 .23 


.30 


.32 


Obstetric Nursing 




.31 


.23 


.31 


.35 


Pediatric Nursing 






.31 


.34 


.34 


r = .20, p <.05; r=: 


.28, 


p<.01; 


r = .39, p < .001 







THE CANADIAN NURSE 



43 



relations with marks. For the 1967 
year, significant correlations were 
established between COT Total scores 
and 1 3 out of 27 (48 percent) academic 
and/or clinical marks; for the 1968 
class, 8 out of 20 (40 percent) of the 
academic and/or clinical marks; and 
for the 1969 class, 9 out of 19 (47 
percent) of the academic and/or clinical 
marks. 

Science scores followed closely by 
those of the Verbal test also showed 
significant correlations with marks, 
although correlations were not found 
to exist between these test scores and 
as many marks as was the case with 
the COT Total scores. Approximately 
one-quarter to one-third of the aca- 
demic and/or clinical marks each year 
were found to be correlated with COT 
Science and Verbal scores. An even 
lower percentage of marks was found 
to be correlated with the Numerical 
and Social Science scores, the latter 
showing the least number of correla- 
tions with marks. 

The mean COT percentiles for 
each group averaged across the three 
years are presented in Table 2. In each 
year the five scores were found to dif- 
ferentiate the rejects from the other 
three groups at the 0.05 level of sta- 
tistical significance or higher. 

Since the COT, a measure of scho- 
lastic ability, the Ravens, a test of intel- 
ligence, and the intelligence dimen- 
sion of the 16PF are all instruments 
that tap intellectual functioning, it 
seemed reasonable to compare them 
in terms of predictive value. Because 
of the many significant correlations 
established between COT scores and 
school and RN examination results, 
the COT stands out as an excellent 
predictive instrument. On the other 
hand, the Ravens test employed in the 
screening of the 1967 and 1968 appli- 
cants to St. Michael's School of Nurs- 
ing, was found to be correlated with 
only two school marks in 1967 and 
four in 1968, although it did show 
significant correlations with three or 
four RN examinations in 1967, but 
only one in 1968. 

The intelligence dimension of the 
16PF was found to be correlated with 
44 THE CANADIAN NURSE 



TABLE 2 

Mean CQT Percentiles for Each Group 
(N = 665) 





Class 

(N=246) 


Drop-Outs 

(N=65) 


ADNC 

(N=130) 


Rejects 

(N=224) 


CQT Percentile 
Total 


68.37 


66.66 


65.96 


40.37* 


Science 


51.19 


48.84 


55.28 


35.21* 


Social Science 


49.84 


50.99 


40.21 


32.54* 


Verbal 


65.34 


63.66 


66.82 


42.43* 


Numerical 


82.55 


77.35 


75.99 


63.76* 


* p < .05 



all four RN examination results in 
1968, but showed no correlations with 
the 1 969 RN examination results. 

Personality test results 

Although the intelligence dimen- 
sion of the 16PF was not shown to be 
a consistent predictor of success in 
nursing as defined in terms of RN ex- 
amination results, this is not to say that 
the other dimensions of the 16PF were 
not valuable predictive tools. For the 
1969 group, the reserve, emotional 
stability, humility, restraint, practicali- 
ty, conservatism, and control factors 
showed significant correlations with the 
RN examination results. In addition, 
the 1 6PF was a valuable instrument in 
differentiating between the groups. 

The dimensions on the 16PF that 
differentiated between the class and 
dropout groups in 1968 were those of 
emotional stability, self-reliance, and 
practicality, and, in 1969, reserve. As 
far as differences in reserve were con- 
cerned, the dropouts were much more 
outgoing, warmhearted, easygoing, and 
participating. These are desirable char- 
acteristics; but when they are operating 
in a student's personality to the extent 
that she is spending considerable time 
fulfilling such aspects other personality, 
she is not likely spending as much time 
as is required at her studies. 

As far as the 1 6PF factors that dis- 
criminated between these two groups 
in the 1968 year are concerned, the 
class were found to be more stable emo- 



tionally and less easily upset; more 
self-reliant and realistic; and more prac- 
tical, that is, careful, conventional, 
more regulated by external realities 
than were the dropouts. 

Another instrument used in the Pre- 
entrance Nursing Candidate Selection 
Battery was the General Information 
Ouestionnaire. Analyses of variance 
indicated that the following scales dif- 
ferentiated between the class and drop- 
out groups: decision-making, courtesy, 
moral standards, responsibility, science, 
persuading others, listening, tolerance 
and study habits. In most cases it was 
the dropouts who rated themselves high- 
er on these scales. This is consistent 
with the unrealistic attitudes reflected 
in their 16PF profiles. 

Although the self-ratings taken from 
the General Information Ouestionnaire 
differentiated between the class and 
dropouts, they were not particularly 
valuable predictive instruments in terms 
of their ability to establish significant 
positive correlations with academic 
and/or clinical marks and RN examina- 
tion results. Also, the Wish-To-Be-A- 
Nurse, Reaction-to-Failure, and Atti- 
tude-to-School scores derived from the 
FSSCT were not particularly valuable 
as far as their predictive ability was 
concerned. Because the Wish-To-Be- 
A-Nurse score was found to be correl- 
ated with school marks as well as RN 
examination results in 1967, it was also 
analyzed for the 1 968 and 1 969 classes. 
In 1968 it was found to be correlated 
JANUARY 1971 



with only one mark, that of psychology 
II, and in 1969, with one RN examina- 
tion, that of medical nursing in which 
a negative correlation (r = -.20) was 
established. In other words, the greater 
the applicant's wish to be a nurse as 
reflected in her FSSCT, the poorer her 
performance on the medical nursing 
examination. 

Such an inverse relationship sug- 
gests strongly that the applicant who 
responds to sentence stems of the FSSCT 
with completions reflecting an inter- 
est in becoming a nurse, may not have 
the necessary abilities required to 
achieve her goal, nor the abilities that 
make for relative success in nursing as 
measured by RN examinations. 

The Wish-To-Be-A-Nurse score, de- 
rived from the FSSCT, significantly 
differentiated between the rejects and 
the other three groups in the 1967 year, 
with the rejects obtaining much higher 
scores than those of the other groups. 
Such a finding is consistent with the 
inverse relationship discovered between 
Wish-To-Be-A-Nurse scores and RN 
examination results, and can be inter- 
preted in the following way: Those 
applicants who are rejected presented 
an aggrandized view of themselves, a 
possible reflection of the use of a great 
deal of psychological denial, whereas 
those applicants who were accepted had 
a more realistic view of themselves. 

A similar choice of interpretation 
can be made regarding the significantly 
higher, that is, more positive, Reaction- 
to-Failure scores obtained by the 1967 
dropouts. On the other hand, the signif- 
icantly higher Reaction-to-Failure 
scores obtained by the dropxiuts could 
well have been a reflection of the very 
realistic attitudes toward failure in that 
they were either failing academically 
or at least were not performing par- 
ticularly well. They were able to look 
at their performance in a realistic light 
and make the appropriate decision. 

The former explanation of the drop- 
outs' higher Reaction-to-Failure scores, 
however, is more consistent with the 
findings on the MMPI. The dropouts 
had significantly lower depression scale 
scores than did the class members in 
the 1967 group. On the surface, it 
JANUARY 1971 



would appear that the dropouts were 
less depressed than were the class mem- 
bers; such an interpretation is highly 
unlikely however. Rather, it seems 
more probable that the dropouts were 
using a certain degree of psychological 
denial and this resulted in lower de- 
pression scale scores for them. A similar 
use of denial was demonstrated in the 
dropouts' somewhat unrealistic 16PF 
profiles. These relatively consistent 
findings regarding the dropouts' dif- 
ferential performance on the personality 
tests strongly supports the need for the 
inclusion of such instruments in any 
pre -entrance nursing candidate screen- 
ing battery. 

Conclusion 

In terms of predictive ability, as 
measured by correlational relationships 
found to exist between psychological 
tests and marks, the instruments em- 
ployed in the St. Michael's Hospital 
Psychological Services Pre-Entrance 
Nursing Candidate Selection Batteries 
can be ranked in the following order: 
COT. 16PF, GIQ, FSSCT, Ravens, 
and MMPI. The CQT and 16PF, in 
particular, were found to be valuable 
predictive tools: the former in assessing 
achievement factors, the latter, person- 
ality. In addition, the COT was a valu- 
able instrument in differentiating be- 
tween the rejects and the other three 
groups (class, dropouts, and ADNC); 
the 16PF was valuable in differentiat- 
ing between the four groups (class, 
dropouts, ADNC, and rejects), and be- 
tween the class and dropouts. 

The GIO also made an important 
contribution in discriminating between 
the class and dropouts. These three 
tests (CQT, 16PF and GIO) could be 
used to advantage in any pre-entrance 
nursing candidate selection program. 
The use of such tests is of no small im- 
portance; it can lead to better selection 
procedures with the possibility of at 
least one important result — fewer 
dropouts. 

The exciting area of study of which 
Ogston and Ogston recently wrote" is 
no longer in the discussion stage, at 
least at St. Michael's Hospital in To- 
ronto. Analyses of personality and 



achievement tests have been conducted 
and have differentiated successful stu- 
dents from unsuccessful ones. 

References 

1. Dent, D.E. A study of the predictive 
efficiency of one pre-entrance nursing 
test battery at one selected accredited 
three-year diploma school of nursing. 
Unpublished M.Sc.Ed. Thesis. Ann 
Arbor. University of Michigan. 1962. 

2. Ihkl. 

3. Bennett. G.K.. Bennett. M.G.. Wallace. 
W.L., and Wesman, A.G. Caliche Qtui- 
lification Test Manual. New York. 
Psychological Corporation. 1961. 

4. Ihiil. 

5. I hill. 

6. Korer. B.R. A structured sentence 
completion test. Joiinuil of Projective 
Techniques 14; 15-30, 1950. 

7. C'oville. W.J. General Infornwtion 
Questionnaire. New York. Coville. 
1966. 

8. Ravens. J.C. Guide To the Sfaiiilaril 
Pro)>ressive Matrices. London. Lewis, 
1938. 

9. Hathaway. S.R, and Mckinley, J.C. 
Minnesota Multiphasic Personality 
Inventory Manual. New York, Psy- 
chological Corporation. 1961. 

10. Cattell. B. and Eber. H.W. Si.xteen 
Personality Factor Questionnaire. 
Chicago, Institute for Personality and 
Ability Testing. 1954. 

1 I . Ogston. D.G. and Ogston. K.M. Coun- 
seling students in a hospital schotil of 
nursing. Canail. Nurse 66:4:52-3. 
April 1970. ^ 



THE CANADIAN NURSE 45 



MEDLARS and you 



Nursing, along with other health professions in Canada, now has a new 
reference resource for bio-medical literature. This resource is the Canadian 
MEDLARS Service, which will be invaluable for research and information 
required for current practice. 



Ann O. Nevill, B.Sc, AMLS, and Margaret 
L. Parkin, B.A., B.L.S. 



When first seeing the term "MEDLARS." 
many nurses might well ask, "What is 
it?" MEDLARS an acronym for Medi- 
cal Literature Analysis and Retrieval 
System. It is a computerized system 
that makes possible the production of 
bibliographic services such as Index 
Medicus and the International Nursing 
Index (INI) from the machine sorted 
citations indexed from some 2,300 
separate journals from all over the 
world. 

MEDLARS was developed at the 
National Library of Medicine in 
Washington specifically to facilitate the 
widely used index to biomedical per- 
iodical literature, arranged by subject 
and by author. Index Medicus has been 
published since 1879 under various 
names and, since 1960, has appeared 
monthly with annual cumulations. The 
first computer-based issue was published 
in January 1964. Some 15 nursing 
journals, including The Canadian 
Nurse, are covered by Index Medicus. 

Also produced by MEDLARS is INI, 
which first appeared in 1966. The INI 
uses stored data from over 1 80 nursing 
journals, and nursing content from over 
2,000 non-nursing journals. About 50 
percent of the citations are in English, 
and about 6 percent are in French. 

The INI is the only nursing index 
giving access to French-language art- 
icles. This is important for Canadian 
nurses who may be particularly interest- 
46 THE CANADIAN NURSE 



ed in locating both English-language 
and French -language references. Many 
may not realize that, although the titles 
are printed in English in the subject 
part of the index (with a code (Fre) in 
the right-hand margin), the article 
appears in the author/title listing in 
the French language. To assist French- 
language users of INI, a cross-reference 
list relating standard subject headings in 
French to the INI English subject head- 
ings is available from the librarian of 
the Amer'can Journal of Nursing 
Company, 10 Columbus Circle, New 
York, N.Y., 10019. 

How information is stored 

All journals indexed into MEDLARS 
are held at the National Library of 
Medicine (NLM) in Bethesda, Mary- 
land, U.S.A. The indexing, however, is 
done by trained subject specialists lo- 
cated not only at the NLM, but abroad 
in such countries as France, Great 
Britain, Israel, Sweden, and Japan. 
Each article or item is listed under 
appropriate headings chosen from a 
list, or thesaurus, of about 8,000 ap- 
proved headings, called Medical Subject 
Headings {MESH). 



Mrs. Nevill is MEDLARS Analyst, Cana- 
dian MEDLARS Service, National Science 
Library, Ottawa. Miss Parkin is Librarian 
at the Canadian Nurses' Association. 



Articles are also examined for special 
information, such as age groups of 
patients, pregnancy, human or animal 
studies, geography, and clinical re- 
search, and will have additional entries 
to cover these areas. Each article is 
cited in Index Medicus and the INI only 
under its most important concepts. 
However, all subject entries used for the 
article are stored on magnetic tape for 
future machine retrieval. 

For example, an article on nursing 
care of diabetics would be listed in INI 
both under nursing care and diabetes. 
However, it may also have been 
relevant to diabetes in pregnant women 
between 25 and 35 years of age in 
Prince Edward Island. The article could 
be retrieved under these additional 
aspects, that is, pregnancy, age, and 
geographic location, in a machine search 
for articles involving any of these 
specific requirements. 

Each citation in the MEDLARS stor- 
age, therefore, contains: 1. authors' 
names; 2. English title and/or English 
translation and the original language; 3. 
abbreviated journal title; 4. volume, 
page, date of publication; and 5. subject 
headings describing the contents. 

How information is retrieved 

So much for how the information is 
stored. How is it found again or re- 
trieved? First of all, in printed recur- 
ring bibliographies, such as the already 
JANUARY 1971 



discussed Index Medians and the 
International Nursing Index and some 
16 others in specialized areas. It may 
also be retrieved by one-time retro- 
spective bibliographies called demand 
searches. If an area of interest is too 
complex or detailed to be found 
readily in available indexes or biblio- 
graphies, a request is programmed into 
the computer in the special terms of 
MESH. The resultant process in the 
computer is a matching one. Terms in 
the search request are matched against 
the stored citations, and, when there is 
a match, an article is retrieved and 
the citation is printed out. 

There are MEDLARS centers around 
the world where these demand searches 
can be processed without having to go 
to the National Library of Medicine in 
the United States. One of the newest of 
these centers is the Canadian MEDLARS 
Service, based at the Health Sciences 
Centre at the National Science Library 
in Ottawa. Here a search analyst trans- 
lates requests for information into the 
necessary combinations of terms to 
retrieve that information from the 
computer. 

At present, requests for demand 
searches are programmed by the Cana- 
dian MEDLARS Service and processed 
through the computer facilities at Ohio 
State University in Columbus, Ohio. 
However, when the new MEDL.ARS II 
computer becomes operational some- 
time in 197 1, the programs will be suit- 
able for the NRC's computer facilities, 
and requests will be fully processed at 
the Canadian center. 

When a request is processed, the 
computer automatically searches the 
literature of the past 2'/2 to 3 V2 years. 
Each July, a year is cut from the search 
range; for example, a search now runs 
from January 1968 to date. After July 
1971, it will cover from January 1969. 
If this initial search coverage is not 
enough, earlier citations on any tape, 
back to 1964, can be done. 

How to use MEDLARS 

Nurses working in educational insti- 
tutions or involved in clinical or other 
forms of research will find the .MED- 
LARS demand search service partic- 
ularly valuable. But how do you, as one 
of these nurses, go about using MED- 
LARS? 

When you need material for a topic 
on which you can find limited or no 
information in the INI or Index Med- 
icus, you should first discuss your 
lANUARY 1971 



problem with the reference librarian in 
your own institutional library, or by 
correspondence with the Canadian 
Nurses" Association librarian. The CNA 
library has prepared many bibliog- 
raphies that may either supplant or 
supplement a MEDLARS search. 

If it is definitely determined that a 
MEDLARS search is required, a MED- 
LARS request form should be obtained, 
again from the relevant institutional 
library or from the CNA library (50 
The Driveway, Ottawa 4) or from the 
Canadian MEDLARS Service (National 
Science Library, National Research 
Council of Canada, 100 Sussex Drive, 
Ottawa). The completed form can be 
submitted through any of these chan- 
nels. 

How successful a MEDLARS demand 
search will be depends on such inter- 
dependent factors as: 

• How well you fill in the narrative 
statement on the form, explaining 
the information you need. 

• The availability of MESH terms to 
describe the request. (These are 
selected by the search analyst at the 
Canadian MEDLARS Service prim- 
arily on the basis of your narrative 
statement.) 

• The availability of information on 
your topic within the time span (i.e., 
the initial 21/2 or V/z years) of the 
search, and in the journals covered 
by MEDLARS. 

• How well the required articles have 
been indexed into the system, and 
how well the search analyst translates 
your need into MESH terms. 

When you receive your bibliography, 
it will usually be arranged alphabet- 
ically by author. The bibliography may 
be divided into two or three sections to 
separate two or three different aspects 
of your requests, to separate specific 
from general articles, or to group 
articles by languages. To help you inter- 
pret the bibliography, the terms of the 
search formula will be enclosed, as 
well as information about acquiring 
articles in the bibliography and an 
evaluation form that you should com- 
plete and return. You can ask for the 
bibliography to be done on continuing 
computer paper or 3" x 5" cards. Each 
citation will include complete biblio- 
graphic information, the original lan- 
guage of the article if it is other than 
English, and a list of all the indexing 
terms that were applied to the article. 



There are some restrictions on 
what you should ask for as a MEDLARS 
search. For example, you should not 
request: 

1. Searches of the total MEDLARS file 
of stored data, i.e.. back to 1963. 
Experience has proven that the most 
relevant data is usually in the past 
2V2 to 3 years. For earlier data, 
the INI and the Index Medicus 
should be used. 

2. Author searches. This data is readily 
available in INI and Index Medicus. 

3. Verification of specific bibliographic 
citafions. Again, this data is readily 
available elsewhere. 

4. Bibliographies on single subjects, for 
example, university programs in 
nursing, which may easily be coor- 
dinated. This particular example can 
be found in the INI under Nursing 
Education — Baccalaureate. 

5. Specific data on facts that can be 
readily found in handbooks and 
directories. For example, the number 
of graduates from baccalaureate 
nursing programs in Canada in 1965. 
This is easily found in Countdown 
1967. 

MEDLARS orientation programs 
slide-illustrated presentations of vary 
ing lengths (up to a full day) are avail- 
able to groups of nurses, health science 
practitioners, and librarians who wish 
to become more familiar with the sys- 
tem. For information on arranging such 
a program for a group or on participat- 
ing in a program if one should be 
arranged in your area, write to the 
Canadian MEDLARS Service. 



The National Science Library has 
so far absorbed the cost of MEDLARS, 
but a charge probably will be started 
during 1 97 1 . What this cost will be has 
not been decided, but it will probably 
be between $30 and $50. MEDLARS 
searches can also be done on a once-a- 
month basis as a current awareness 
service. The charge for this service is 
$ 1 00 per year. 

Canadian nurses will undoubtedly 
make use of MEDLARS Services. In 
doing so, nursing research and studies, 
education and service in Canada will 
benefit accordingly. ^ 



THE CANADIAN NURSE 47 



idea 
exchange 



Traveling Maternity Workshops 



In the spring of 1970, a unique series 
of maternity nursing workshops was 
held in Alberta. Instead of inviting 
nurses to converge upon a central loca- 
tion, the same workshop was taken 
to them at various centers through- 
out the province. The series was co- 
sponsored by the University of Alberta 
Continuing Education in Nursing and 
the Alberta department of public 
health, under the provision of a federal- 
provincial grant. (Project Number 
608-13-11.) 

The workshop leader in all centers 
was the coordinator of the University 
of Alberta's advanced practical ob- 
stetrical course. Because of the diversity 
of hospitals in the various sized com- 
munities, content was made pertinent 
by including resource persons from 
the immediate locale, who were aware 
of the region's problems. 

The tlve-day workshop, divided 
into four days of theory and one clin- 
ical day was to provide participants 
with increased knowledge of current 
concepts in maternal and newborn care. 
Although key lectures were related 
to new concepts and trends in obstet- 
rics, the central focus for discussion 
was on nursing principles. 

In the larger centers, groups were 
deliberately structured to allow the 
maximum amount of interchange be- 
tween participants from the different 
hospitals. In the smaller centers, the 
workshops were less structured and, 
because of reduced attendance, much 
of the discussion took place in one 
48 THE CANADIAN NURSE 



group. Exchanging ideas and methods, 
learning and discussing how adapta- 
tions can be made according to the 
various working environments, and 
where new medical knowledge is having 
effect on the nurses' activities, were the 
major points of interest. 

The workshops were specifically 
oriented to the staff nurse and the nurse 
in the rural hospital, and the content 
was arranged so problems could be 
ventilated, possible solutions aired, and 
some of the cobwebs of routine and 
lethargy dusted away. An aura of in- 
volvement and an eagerness for know- 
ledge created a stimulating environment 
for discussion. 

The fourth day of the workshop was 
spent by the participants as observers 
in the clinical area of local hospitals. 
Without the pressures of time or the 
stress of multiple duties, the nurses were 
able to observe care being given and to 
practice interviewing techniques to help 
them assess the individual patient's 
needs. In strange environments, the 
blinkers of routine and familiarity were 
removed and the total picture of the 
individual in an institutional setting 
could be observed objectively. Short- 
comings were seen and evaluated, new 
ideas were examined and considered, 
and high quality care was commended. 
Much that was learned in the clinical 
day could not be verbalized, as the 
experience was a personal reexamina- 
tion by each nurse of the level of com- 
mitment to quality care. 

In Alberta, the College of Physi- 



cians and Surgeons has an active peri- 
natal mortality committee. Members 
of the committee spoke to the work- 
shop participants about perinatal prob- 
lems, placing particular emphasis 
on the "high risk" baby. The physicians 
also stressed the importance of com- 
munication, pointing out that, given 
information the nurse, often the one 
responsible for detecting emergency 
situations before they reach the hazar- 
dous level, will be alert to the potential 
problems of the mother and her infant. 

Alberta nurses have been enthusi- 
astic about this new type of workshop. 
One advantage is that many nurses have 
been reached in the small rural hospi- 
tals, where some participants might 
not have been selected to attend a cen- 
tralized workshop, and others could 
not have abondoned their home com- 
mitments to attend an out-of-town 
workshop. The reduction in traveling 
expenses also allowed more nurses 
from the same institution to attend. 

Nurses feel the need for this type 
of continuing education. They want 
increased knowledge and clinical ex- 
pertise. We hope we will be able to 
answer their needs by conducting more 
traveling maternity workshops in the 
future. — Pat Hayes is Coordinator 
of the Advanced Practical Obstetric 
Program at the University of Alberta, 
Edmonton. ^ 



JANUARY 1»71 



k- 



February 1971 




The 



MRS MT 

2368 MPWITOE AVE^ 

ONT u^-^jOfc51 1 096 



Canadian 
Nurse 





sending someone to a conference? 
— here are some tips 

catchbasins^ debentures, 
subsidies, and garbage cans .... 



preadmission orientation 
for children 





A NEW WAY TO WEAR 



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THE PANT-A-WAY 



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For the Nurse 
who cares 
enough 
to be 
involved . . . 



TEXTBOOK OF MEDICAL-SURGICAL NURSING 

By Lillian S. Brunner, R.N., M.S., 

Charles P. Emerson, Jr., M.D., L. Kraeer Ferguson, M.D., 

and Doris S. Suddarth, R.N., M.S.N. 

Designed to develop the highest degree of clinical 
expertise, this edition emphasizes the pathophysiolo- 
gic/psychosocial factors involved in patient care. 
Included is entirely new or expanded material on 
vascular/cardiac/ respiratory intensive care nursing/ 
neurologic and neurosurgical problems/ burns/gen- 
itourinary and gynecologic disorders/ rehabilitative 
measures. 

1031 Pages 387 Illustrations 2nd Edition, 1970 $14.95 



Hew 

NURSING IN THE CORONARY CARE UNIT 

By LaVaughn Sharp, R.N., M.A., 
and Beatrice Rabin, R.N. 

Concisely written by well-qualified authors and amply 
illustrated with graphs and charts, this timely book 
guides the nurse in making decisions and initiating 
appropriate measures for optimum care of the co- 
ronary patient. Coverage encompasses diagnostic 
measures, including interpretation of electronic mon- 
itoring systems, etiology, treatment, psychological re- 
sponses, and nursing intervention for all types of 
conorary artery disease — vital information for the 
student or graduate who may be required to func- 
tion as a nurse clinician in the CCU. 



BEHAVIORAL CONCEPTS and 
NURSING INTERVENTION 

By Carolyn E. Carlson, R.N., M.S., Coordinator. 
With Sixteen Contributors. 

This is the first book to Identify and examine in depth 
relevant concepts from the behavorial sciences and 
to demonstrate their application to nursing. The ma- 
terial in this pioneering book is fresh, original and 
practical. Content provides valuable insight into the 
emotional problems of illness and hospitalization and 
their influence on the patient. Chapter subjects range 
from denial of illness, empathy, and body image 
through ambivalence, shame, grief, hostility, and con- 
trol of the nurse-patient relationship. 



213 Pages 



89 Illustrations 



1970 



$8.25 



341 Pages 



1970 



Paperbound, $5.50 
Clothbound, $7.75 



J. B. LIPPINCOTT COMPANY OF CANADA LTD. 

60 FRONT ST. WEST 
TORONTO 1, ONT. 



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Please send me the following books: 

D TEXTBOOK OF MEDICAL-SURGICAL NURSING 

D NURSING IN THE CORONARY CARE UNIT 




$14.95 
8.25 



D BEHAVORIAL CONCEPTS AND NURSING INTERVENTION D Pap«rbound, $5.50 

D Clothboond, 7.75 



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Name Position 

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n Payment enclosed D Charge and bill me 

Lippincott books moy be returned within 30 days if you 

are not fully satisfied. 

CN - 2-71 



FEBRUARY 1971 



THE CANADIAN NURSE 1 




SOME STYLES ALSO AVAILABLE IN COLORS . . . SOME STYLES 3I/2-I2 AAAA-E, 17.95 to 24.96 
For a complimentary pair of white shoelaces, folder showing all the smart Clinic styles, and list of stores selling them, write: 



THE CLINIC SHOEMAKERS 



Dept. CN-2, 7912 Bonhomnne Ave. • St. Louis, AAo. 63105 



The 

Canadian 
Nurse 



^ 

^^p 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses' Association 



Volume 67, Number 2 February 1971 

25 A Look at the Francis Report on the 
Status of Women in Canada 

27 Catchbasins, Debentures, Subsidies 

and Garbage Cans M.M. Conroy 

29 Preadmission Orientation for Children 

and Parents M.J. Brown 

32 Carotid Artery Stenosis with Transient 

Ischemic Attacics G. VanderZee 

36 Sending Someone to a Conference? 

Here Are Some Tips A. McKone and F. Kuc 

38 The Child with Hurler's Syndrome M. Brenchley 

40 Idea Exchange M. Schumacher, C. Koole 

42 Information for Authors 

The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 

4 Letters 7 News 

15 Names 18 New Products 

22 In a Capsule 44 Research Abstracts 

47 Books 50 AV Aids 

52 Accession List 54 Dates 

71 Index to Advertisers 72 Official Directory 



Executive Director: Helen K. Mussallem • 
Editor: Virginia A. Lindabury • Assistant 
Editors: Liv-Ellen Lockeberg • Production 
Assistant: Elizabeth A. Slanlon • Circula- 
tion Manager: Bcrjl Darling • Advertising 
Manager: Ruth H. Baumel • Subscrip- 
tion Rates: Canada: one year, S4.50; two 
years, $8.00. Foreign: one year, $5.00; two 
years, $9.00. Single copies: 50 cents each. 
Make cheques or money orders payable to the 
Canadian Nurses' Association. • Change of 
Address: Six weeks' notice; the old address as 
well as the new are necessary, together with 
registration number in a provincial nurses' 
association, where applicable. Not responsible 
for journals lost in mail due to errors in 
address. 



Manuscript Information: "The Canadian 

Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in india ink on while paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles 
sent, nor to indicate definite dates of 
publication. 

Postage paid in cash at third class rate 

MONTREAL, P.O. Permit No. 10,001. 

50 The Driveway, Ottawa 4, Ontario. 

Canadian Nurses' Association 1971. 



Editorial 



FEBRUARY 1971 



In 1967, the setting up of a Royal 
Commission to investigate the status 
of women in Canada gave the news 
media a heyday: editorials ridiculing 
the investigation appeared in almost 
every newspaper; television commen- 
tators made facetious remarks and 
were anything but straight-faced in 
their reporting — in fact, few tried 
to hide their belief that the Commissio 
was a big joke, something that would 
be costly, yet immaterial; cartoonists 
got out their drawing boards — the 
same ones used by their predecessors 
when women were struggling to achiev 
franchise — and depicted women as 
farcical, masculine figures trying to 
take over the male role in society. 

But the news media were not alone 
in deriding the Commission and its 
objectives. Few persons, including 
politicians, took the issue of women's 
rights seriously; men joked about it, 
either because they were so entrenched 
in their thinking that they saw no 
discrimination or because they wished 
to maintain the status quo; and women 
seemed embarrassed to discuss it, 
probably because they feared they 
would be labeled "aggressive females" 
by the opposite sex. 

Well, the joke is over. Anyone 
who has read the Commission's digni- 
fied and lucid report and still believes 
women are not discriminated against 
in our so-called "just society" is either 
a dyed-in-the-wool preserver of injus- 
tice or a victim of myopia. But how 
many have read it? Judging from the 
apathetic response to the report, the 
answer must be "few." 

Every nurse should read this report 
(available from Information Canada, 
Ottawa, or from any bookdealer for 
$4.50), react to it, and send her or his 
response to members of parliament 
and to the prime minister. As the 
Commissioners state: "At issue is the 
opportunity to construct a human 
society free of a major injustice which 
has been part of history .... Men, as 
well as women, would benetit from a 
society where roles are less rigidly 
defined " — V.A.L. 

THE CANADIAN NURSE 3 



letters { 



Letters to the editor are welcome. 

Only signed letters will be considered for publication, but 

name will be withheld at the writer's request. 



Your help is needed 

With the use, in 1 97 1 , of the new stand- 
ard registration form by all professional 
nurses' licencing boards in Canada, 
we will have a considerable amount of 
statistical information on nurses that 
was not previously available. The addi- 
tional data stemming from the new 
form will make it possible for us to add 
substantially to our knowledge about 
nursing manpower resources in this 
country. 

The data should provide a much 
more accurate and detailed picture of 
the composition of our nursing force 
than we have had before. In addition, 
it should be possible to study in greater 
detail several facets of the career pat- 
terns of professional nurses that will 
assist us in the development of future 
planning with respect to our nursing 
resources. The factors we are particu- 
larly interested in as having a signifi- 
cant bearing on planning are attrition, 
mobility, and average working life of 
the professional nurse. 

We would greatly appreciate it, if 
each nurse would fill in the informa- 
tion requested as completely and accu- 
rately as possible. The social insurance 
number is particularly important in 
studying career patterns of nurses and 
therefore, we would ask everyone to 
please be sure to include her correct 
number. 

The results of these studies should 
be interesting and of value to each 
nurse in Canada. — Dr. Beverly Du- 
Gas, Nursing Consultant, Dept. of Na- 
tional Health & Welfare, and Rose 
Imai, Research Officer, Canadian 
Nurses' Association. 



Nurse makes comeback 

1 was prompted to write to The Cana- 
dian Nurse after reading the letter to 
the editor, "Part-time nurse disillusion- 
ed," from R.N., Quebec (Sept. 1970). 

I, too, came back to nursing — not 
after one year when medications and 
procedures were still fresh in my mind, 
but after 14 years. I had no knowledge 
of the different types of drugs used, as 
in my day a patient was cured with 
aspirin, sulpha, and sodium bicarbonate. 

When I returned to work it took a 
while to realize that Sparine and pro- 
mazine were the same drug. Once I 
finally learned to say "dihydrostrep 
tomycin" without stuttering, it was 
removed from the market. Even 

4 THE CANADIAN NURSE 



medical terms were vague. When one 
doctor asked me if his patient was 
having melena, I replied that I didn't 
know as I was on medications. 

I have worked in two hospitals in 
the 1 1 years since I returned to nursing. 
Both have offered excellent inservice 
programs. I have also been fortunate in 
having a head nurse who had also been 
away from nursing and recognized my 
plight, and instructors and supervisors 
who answered hundreds of my ques- 
tions courteously. 

There are times when nurses resent 
a new employee offering suggestions. 
There are also time when the word 
"part time" sounds so alien. However, 
I have worked toward the goal of being 
respected as a part-time nurse who did 
a good day's work with a smile because 
she liked what she was doing. 

One thing that is never outdated is a 
nurse's ability to give good nursing care. 
When I returned to nursing I may have 
been outdated as far as procedures and 
drugs were concerned, but I had 14 
years of living experience that was 
extremely useful in many instances 
when patients needed someone to 
listen. — M. Doreen Stewart, Reg. N., 
Chatham, Ontario. 



Mistakes, maybe — perfection, a must 

I am deeply indebted to Dorothy S. 
Starr for her article "Students Have a 
Right to Make Mistakes" (Dec. 1970). 
It is, however, unfortunate that she 
places so much emphasis on the right 
of students to fail and, at the same 
time, writes so negatively of present 
nursing practice. 

Surely all nursing is a process of 
problem-solving and, consequently, 
all nurses are learners. Are not divisions 
false? The onus of responsibility is 
unquestionably on the curriculum 
developer and/or the clinical instructor 
to: (a) select experiences appropriate 
to the students' needs and capabilities, 
and prior to these experiences, make 
available sufficient information and 
establish the related principles to allow 



Letters Welcome 

Letters to the editor are welcome. Be- 
cause of space limitation, writers are 
aSked to restrict their letters to a 
maxunum of 350 words. 



formulation of an acceptable solution: 
and (b) intervene when the students 
selection and/or combination of data 
appears to be leading to a solution 
incompatible with safe care — this 
is the patient's right. 

Again, even in our most routine 
tasks, there is room for creativity, i.e. 
not merely to see the situation as it 
really is, but to see it as it might be- 
come and then to intervene appro- 
priately. This reality of the situation, 
the first essential phase of the process 
of creativity, often appears to rank 
low in the minds of our educators. 

Would-be nurses must learn to accept 
a difficult and demanding role, and it 
is best to begin early. Teachers, minis- 
ters, and others to whom Mrs. Starr 
refers, do indeed affect some aspects 
of the care for human life, but the nurse 
is concerned with nothing less than 
that very life itself. 

Mistakes do occur — they are not 
only acknowledged, they are recorded. 
A current example is the recording by 
nurses on the various units of what is 
seen, heard, or done. Auditors then 
study these data, attempt to solve 
presenting problems in a scientific 
manner, and continue the develop- 
ment of a better nursing program. 

Therefore, in my opinion, despite 
the human frailities of its practitioners 
and would-be practitioners, nursing is 
a one-way street, and its direction is 
clearly toward perfection. — G. Mid- 
dleton, R.N., M. Sc. (A), Ottawa: 



Are we for life or death? 

The recent controversy over the liber- 
alization of abortion legislation is but 
one of the many conflicts of contem- 
porary life. As such, it is impossible 
to understand it apart from some of 
the deeper issues that challenge civi- 
lization at its very roots. 

If one scans the literature or at- 
tempts to analyze the experience of 
daily living, one observes on all fronts 
a value crisis. This phenomenon repre- 
sents a pattern of valuelessness, a sense 
of emptiness, a lack of purpose, a 
desperate quest for meaning, and some- 
times an unending search for pleasur- 
able fascinations both cognitive and 
appetitive. 

Certain pervasive outlooks devel- 
oping over the past four centuries seem 
relevant to the present value crisis. 

FEBRUARY 1971 



They are: naturalism, which, in its 
modern version, tends to deny the 
existence of an order transcending 
nature and sense experience; atheism, 
a mass phenomenon which seeks in the 
denial of God the total affirmation of 
man; and humanism, which sees man, 
himself matter, a product of blind ma- 
terial forces. It is not surprising, that 
these movements, which have penetrat- 
ed every facet of our culture, have 
influenced our value systems and, 
consequently, the manner in which we 
approach everyday problems includ- 
ing the present one of abortion. 

1 he value we place on human life 
is an expression of the value we place 
on the human person. If we view real- 
ity from a naturalistic, materialistic 
humanism, man can be seen merely 
as a "biological organism," or a com- 
plex "electrodynamic field." If our 
fundamental premises are atheistic, 
we allow ourselves the right to create 
and destroy at will without accounta- 
bility to any being outside of or greater 
than ourselves. If we allow for a spir- 
itual, transcendent dimension, we be- 
lieve that man has a principle of life 
that is a share in the divine life. In this 
latter context, man possesses a charac- 
ter of mystery and a dignity that evokes 
a natural human response of reverence. 

The right to life is one of the funda- 
mental values on which Western so- 
ciety has been built. Through its laws, 
society has sought to protect the right 
of human life from the moment of 
conception to the moment of death. 
We are called on today to support or 
not to support these laws that serve as 
guardians of our most cherished rights 
and freedoms. 

In this present controversy, is it 
possible that the profession of nursing, 
with its life-long tradition of reverence 
for the dignity of the human person, 
will opt for a decision that makes pre- 
natal euthanasia legally and culturally 
acceptable? If we exercise this terrible 
freedom loosely, what shall be our 
response when asked to support the 
destruction of "unwanted" older citi- 
zens, misfits, or defectives? In either 
case, the same human life and the same 
human freedom are at stake. 

The Code of Ethics of the Interna- 
tional Council of Nurses begins by 
asserting that the fundamental respon- 
sibility of the nurse is threefold: "... to 
conserve life, to alleviate suffering and 
to promote health." Under the guise of 
alleviating suffering, it would seem that 
some of us assent to the destruction of 
life. Perhaps we need to reflect more 
on our ethical responsibilities. Shall 
we opt for professional ideals or deca- 
dence? — Sister Marie Simone Roach, 
Acting Chairman, Nursing Department, 
St. Francis Xavier University, Anti- 
gonish. Nova Scotia. '& 

FEBRUARY 1971 



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THE CANADIAN NURSE 5 



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news 



RNs React To Abortion Issue: 
Agree CNA Should Take Stand 



Ottawa — At its annual convention 
last June, the Canadian Psychiatric 
Association took the jxjsition that the 
matter of termination of pregnancy 
should be removed from the Criminal 
Code of Canada. It was the first Cana- 
dian medical body to state that abor- 
tion should become strictly a medical 
procedure to be decided by the woman 
and her husband, if she has one, along 
with the physician. 

Under the present Code, a hospital 
committee of three doctors is required 
to decide whether a patient will have 
a legal abortion. 

The Canadian Nurse telephoned 
nurses across the country to ask if they 
agreed with the CPA stand and if they 
thought the Canadian Nurses" Associa- 
tion should take z similar stand. Giving 
their opinions were nurses working in 
many fields — public health, educa- 
tion, psychiatry, gynecology, and oper- 
ating rooms. 

Reactions to the CPA stand ranged 
from, "most definitely I agree" to "I 
can't imagine why it wasn't removed 
from the Criminal Code a long time 
ago," to "I agree with part of it." All 
nurses who were interviewed agreed 
abortion should be removed from the 
Criminal Code. 

Deidre A. Giles, instructor, family 
care, patient care services, British 
Columbia Institute of Technology, 
Burnaby, British Columbia, said, 
"Prohibitive laws are often inconsistent 
with human behavior, as in our present 
abortion law, which causes more tragedy 
than the tragedy of abortion itself." 

Though she does not support abor- 
tion as a means of birth control. Miss 
Giles said: "The problem seems to be 
out of proportion because of the appal- 
ling lack of educational and service 
resources for family planning. Many 
men and women do not practice respon- 
sible reproduction because of fear, 
timidity, ignorance, or poverty." 

FEBRUARY 1971 



Two nurses from the Red Deer Gen- 
eral Hospital, Red Deer. Alberta, 
Esther Thorson, associate director of 
special services and Audrey Thomp- 
son, clinical coordinator, said the ther- 
apeutic abortion committee is unnec- 
essary. "The attending physician knows 
the woman for whom he is asking ap- 
proval for a therapeutic abortion. He 
is in a better position to make a judg- 
ment on the appropriateness of the 
procedure than members of the com- 
mittee." 

They said physicians on the com- 
mittee are notified of the reasons by 
the patient's physician. "Whether or 
not approval is given could depend on 
how articulate the attending physician 
is." 

Citing the present procedure as dis- 
criminatory, they said the woman with 
access to information about the pro- 
cedure for securing a therapeutic abor- 
tion and who can afford to visit a num- 
ber of physicians if necessary, is an 
upper or middle class Caucasian. "Yet 
the woman often in need ot a therapeu- 
tic abortion is not a member of these 
groups," said Miss Thompson and Miss 
Thorson. 

Dorothy Aitken, supervisor of 
gynecology at Victoria General Hos- 
pital in Halifax, Nova Scotia, supports 
the CPA stand up to a point. "We should 
have some sort of control until we have 
better facilities. Our problem is that 
so many abortions are approved by 
the committee and we don't have the 
facilities. We have a waiting list and 
this is bad. 

"We are trying abortion on an out- 
patient basis, but now the operating 
room has the problem of a backlog. A 
{xjssible answer might be clinics set 
up for the purpose," she said. 

Sister T. Castonguay, director of 
nursing service at St. Boniface Gen- 
eral Hospital, St. Boniface, Manitoba, 
said, "Since there is a medical and 



moral component to the decision, I 
would add to the CPA statement that 
both the physician and spiritual or 
moral adviser should be involved in 
helping the woman and her husband, 
if she has one, come to this decision." 

Also wanting to see a religious per- 
son involved is a nurse from St. Mary's 
Hospital, Montreal, Quebec. She be- 
lieves the committee system should be 
retained because, "there should be 
consultation in each case as abortion 
is such an individual thing. The com- 
mittee should be composed of doctors 
and a religious person." 

Taking the opposite view — that 
the committee be eliminated — is 
France St. Martin, head nurse in the 
operating room at the Jewish General 
Hospital, Montreal. She said, "Abortion 
procedures are safer when done as 
soon as pxjssible and the committee 
delays things." In her job at a large 
metropolitan hospital she often sees 
the results of illegal abortion. "People 
are forced to use illegal methods because 
they don't have a doctor who will apply 
to the committee, or they were turned 
down, or they were too late, so they 
resort to something else." 

Also pointing out flaws in the com- 
mittee system was Dorothy Burwell, 
director of nursing service at the Clarke 
Institute of Psychiatry in Toronto and 
associate professor of psychiatric nurs- 
ing at the University of Toronto. She 
said: "I hear all the wrangling that 
goes on. Our patients go through two 
committees, one here at the Institute 
and one at the Toronto General Hospi- 
tal. How many committees should a 
woman have to appeal to? Actually, 
the woman doesn't appear before the 
committee, she really has no say. I think 
that's ethically wrong. 

"There still is a lot of guilt attached 
to abortion," Mrs. Burwell said. "So 
many patients, even those who have 
had a therapeutic abortion, say to me, 
'abortion is still in the Criminal Code, 
so I'm a criminal.' We're loading more 
emotional baggage on the patient. 

"I think society should take another 
look at the unwanted child," she said. 
"In psychiatry I see so many of these 
children ending up as wards of the 
state. Society makes it a criminal offense 
to have an abortion and thus commits 
a crime against the child." 

(Conlinued on page 12) 
THE CANADIAN NURSE 7 




CNA Holds Annual Meeting 
in Ottawa Next Month 

Ottawa — In conformity with its Let- 
ters Patent, issued July 1970, and By- 
laws, the annual meeting of the Cana- 
dian Nurses' Association will be held 
March 31, 1971, in the Chateau Lau- 
rier, Ottawa. 

Previously, under its former Act of 
Incorporation and Bylaws, the Asso- 
ciation held a general meeting biennial- 
ly, and combined business sessions, 
general interest sessions, and social 
events. Activities were reported and 
administrative affairs discussed at 
the business sessions. 

The board of directors, while be- 
lieving the members favor the contin- 
uance of this convention-type of meet- 
ing biennially, realize such an annual 
undertaking would be inadvisable at 
this time. Therefore, the annual meet- 
ing in 1971 will be a one-day business 
meeting on March 31, in Ottawa; the 
1972 annual meeting will be held in 
Edmonton in June and combined with 
general interest sessions and social 
events. The officers are elected for a 
term of two years and the next election 
will be held in June 1972 in Edmonton. 

Any CNA member may attend the 
annual meeting on March 3 1 and each 
provincial association member will be 
represented by its appointed voting 
delegates. The total votes for each as- 
sociation member are based on its 
membership at December 31 immedi- 
ately preceding the annual meeting. The 
appointed voting delegates are the 
voting body for an annual meeting. 

There will be no registration fee 
for the 1971 annual meeting, and pres- 
entation of a current provincial mem- 
bership card will be required for ad- 
mission. 

CNA Board Nominates 
Candidate For ICN 3-M Award 

Ottawa — Jocelyne Nielson is the 
nominee of the Canadian Nurses' .Asso- 
ciation for this year's ICN 3-M Fel- 
lowship. The CNA board of directors, 
meeting in October 1970, approved 
her nomination. 

The $6,000 fellowship offered by 
the 3M Company is awarded annually 
to a nurse selected by the International 
Council of Nurses from nomirices pro- 
posed by national nursing associations. 
The award is used for formal study in 
the nurse's chosen field. 

Mrs. Nielson, formerly of Montreal, 
was awarded the Dr. Katherine E 
MacLaggan fellowship by the Canadian 
Nurses' Foundation in 1970 and is 
8 THE CANADIAN NURSE 



studying for a doctoral degree, major- 
ing in psychology, at the University 
of California School of Nursing. 

The conditions of acceptance of 
nomination set by the CNA board are: 

"If a Canadian recipient of the ICN 
3-M Fellowship receives the award 
during the term for which a CNF fel- 
lowship has been accepted by that 
recipient, the second installment of the 
CNF fellowship will be withheld by 
the Foundation, or, if that second in- 
stallment has been remitted it shall be 
refunded to the foundation upon receipt 
of the 3-M fellowship; 

"And a recipient of an ICN 3-M 
fellowship may not reapply for a CNF 
fellowship for the same program of 
study for which a 3-M award has been 
accepted." 

The criteria for nomination also set 
by the CNA board are: 

"The CNA nominee for the ICN 3-M 
fellowship should be a recipient of a 
CNF award for the final year of study 
for a master's degree or for study 
toward a doctoral degree who: 1 . is 
under 50 years of age; 2. has been 
employed in nursing in Canada for 
not less than five years; 3. has demon- 
strated concern and has participated 
in the promotion of the profession; 
4. is free of employment commitments 
and desires to continue advanced study 
in nursing with the current year; 5. 
will return to employment in Canada 
for a minimum of 2 years; 6. in the 
opinion of the selections committee 
has the potential to give outstanding 
leadership in nursing in Canada." 

Each national nursing association 
was asked by ICN to develop its own 
criteria for acceptance of nomination. 
The CNA criteria does not conflict with 
or duplicate the ICN criteria. 

RNAO Removes Greylisting 

Of Scarborough Health Department 

Toronto, Ont. — With the settling of 
the two-month strike of Scarborough 



Official Notice 

of 

CNA Annual Meeting 

The annual meeting of Canadian 
Nurses' Association will be held 
Wednesday March 31, 1971, in the 
Ballroom, Chateau Laurier Hotel, 
Ottawa, Ontario, commencing at 
0900 hours. Ordinary members of 
Canadian Nurses' Association are 
eligible to attend the annual meeting. 
Guests may attend on invitation by 
the President and/or Board of Di 
rectors. (Reference — Rules and 
Regulations, Section 38.) Presenta- 
tion of a current provincial member- 
ship card will be required for admis- 
sion. — Helen K. Mussallem, Execu- 
tive Director, CNA . 



public health nurses in mid-December, 
the Registered Nurses' Association of 
Ontario has lifted its greylisting of the 
Scarborough Health Department. 

The nurses gained what has been 
called a "partial victory" in the two 
issues that caused them to strike. Car 
allowances have been increased to 
$45.50 from an average of $25 a month. 
Those who drive between 2,000 and 
3,000 miles per month will receive 
$49.50, and those between 3,000 and 
4,000 will get $53.50. 

The other main issue, vacation leave, 
was settled at four weeks vacation after 
15 years of service although they had 
asked for four weeks after one year of 
service. The RNAO says the majority 
of public health nurses in Ontario 
receive such vacation time. 

The Scarborough nurses also receive 
a salary increase of 10 percent for 1970 
and an additional 8 percent for 1971. 
Their salary before increases ranged 
from $6,423 to $7,577 for a nurse 
with a public health diploma or a 
bachelor of science in nursing. The 
new contract also improves their health 
benefits plan. 

Cost Is Minimal To improve 
Street Safety After Dark 

Vancouver, B.C. — Preventive meas- 
ures to improve street safety conditions 
after dark have been recommended in 
a study report on the travel problems 
of hospital employees working night 
shifts. The study was sponsored jointly 
by the Registered Nurses' Association 
of British Columbia, the British Co- 
lumbia Hospitals' Association, the 
Hospital Employees Union, and the 
Psychiatric Nurses Association. 

The findings indicate many hospital 
workers are exposed to the dangers of 
darkened streets when coming off late 
afternoon shifts and going on night 
shifts, reported Dr. Nirmala d. Cheru- 
kupalle, assistant professor, school of 
community and regional planning, 
UBC, who did the study. Many workers 
reported feeling fear when traveling to 
and from work at late hours, she said. 

Improved street lighting and parking 
conditions, patrolled areas around 
major metropolitan hospitals, and par- 
tially subsidized transportation are 
among the recommendations made to 
solve travel problems of such em- 
ployees. Dr. Cherukupalle said reme- 
dies for street safety problems could 
be implemented at a minimal cost by 
individual hospitals and city or munic- 
ipal governments. Residents could be 
asked to leave their front porch lights 
on in badly lighted districts. 

"While the study was confined to 

hospital employees, we are concerned 

with the safety of all citizens whose 

work requires that they be on the streets 

(Continued on page 10) 

FEBRUARY 1971 




M 



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slides through tissue with a keenness you can "feel ". 

Increased Security: Release the "wings" after 
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patient's skin. Thus you have a ready-made anchor 
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(Continued from page 8) 

after dark," said Monica Angus, pres- 
ident of the RNABC, which initiated 
the study. "Many of the recommenda- 
tions in the report could be applied to 
other groups of workers," she said. 

The report is being studied by the 
boards of the sponsoring organizations 
to determine the kind of joint action 
that could be taken to promote imple- 
mentation of the recommendations. 

NBARN Gives Brief 
To Study Committee 

Fredericton, N.B. — The provincial 
government's study committee on nurs- 
ing education received a brief from the 
New Brunswick Association of Regis- 
tered Nurses in December 

Harriett Hayes, NBARN president, 
said the association's proposals would 
improve nursing education for the 
future. The brief details inadequacies 
of the present system and their causes. 

The study committee is looking into 
all aspects of nursing education. 
NBARN hopes the committee's find- 
ings will result in desirable changes in 
nursing education. 

Nurses' Needs And Wants 
Turn Them To Group Action 

Hamilton, Ont. — The organization of 
nurses for collective bargaining in- 
dicates feelings of dissatisfaction. Dr. 
V.V. Murray, associate professor, facul- 
ty of administrative studies, York Uni- 
versity, told 100 administrative nurses 
attending an October workshop. 

"One reason for organization is 
feelings of dissatisfaction, feelings of 
rather wide-spread dissatisfaction. 
I might add that many people say this 
is the main reason. This is not the 
main reason because people get dissa- 
tisfied and don't organize," he said. 

"Dissatisfaction is a function, first 
of all, of what is important to you on 
the job. Why are you working? What 
is the main thing in your work life?" 

Professor Murray listed things 
people find important, such as money, 
autonomy on the job, interesting work, 
job security, opportunity for promo- 
tion, congenial co-workers. 

"Three things influence what is 
important: personal needs, societal val- 
ues, and influences within the organi- 
zation. Among personal things which 
seem important are age, the generation 
gap, education, and marital status. 

"The younger generation tends to 
be more concerned about autonomy, 
freedom to use nursing diagnosis, and 
to work as a team. They feel antipathy 

10 THE CANADIAN NURS£ 



to authority. They want an ability to 
use applied principles without au- 
thority bearing down on them at every 
point," he said. 

Professor Murray feels marital 
status is perhaps more important than 
age in determining a person's working 
needs. Married nurses want flexible 
hours or maybe only day shifts. "This 
can be hard to accommodate in terms 
of rotating shifts," he said. 
Outlining some of the reasons why 
small hospitals get organized tlrst, he 
said, "they have a staff of married 
people who are stuck in the community 
and their choice of employment is 
limited. If dissatisfaction is high, then 
their only choice appears to be to 
organize. 

"Certain needs are amenable to 
being satisfied through the union 
process, particularly those involving 
the economic side," said Professor Mur- 
ray. 

Another speaker at the workshop 
was Dr. F. Isbester, associate profes- 
sor, industrial relations, faculty of 
business, McMaster University. 

"As administrators you are facing 
a new dimension in an employee-em- 
ployer relationship," he said. You are 
not alone in facing this new dimension 
of relationship. This has happened 
many times before and you have much 
company in the ground you are now 
breaking." 

Professor Isbester prefers to see a 
modification of the Ontario Labour 
Relations Act rather than a special 
act for nurses. A modification would 
include many other professional groups. 



^^kazam) 




TRY AS WE MAY WE CAN'T 
GET BLOOD OUT OF A HAT. 
WE NEED BLOOD DONORS 
. . . PEOPLE . . . YOU. MAKE 
A DATE TODAY TO 
GIVE THROUGH 
YOUR RED CROSS. 



+ 



He said he was biased against arbitra- 
tion. He would rather allow strikes 
with provisions for emergency service. 
He believes arbitration is merely the 
treatment of symptoms and not of the 
disease itself, while a strike hits the 
disease. 

"People think twice about going on 
strike, but no one worries about going 
to arbitration as the government pays 
for it anyway. I think resorting to the 
existing provisions of the Labour Re- 
lations Act of the Province of Ontario 
would probably lead to a quicker, 
cleaner resolution of disputes in the 
health care field than resorting to pro- 
visions of the Hospital Labour Disputes 
Arbitration Act," said Professor Is- 
bester. 

The workshop was sponsored by a 
regional committee of the RNAO and 
was attended by nurses who are direc- 
tors, associate directors, assistant di- 
rectors of nursing service, nursing edu- 
cation and health agencies supervisors, 
and head nurses. 

Persons Contemplating Suicide 
Can Often Be Identified 
Social Worker Tells Audience 

Ottawa — Suicidal persons are ambiv- 
alent about dying, according to Sam 
M. Heilig, who addressed an audience 
of 250 at a seminar on suicide held 
November 27 and 28 under the aus- 
pices of the Ottawa Distress Centre. 

Mr. Heilig, co-chief social worker 
at the Suicide Prevention Center and 
Institute for Life Threatening Beha- 
viors in Los Angeles, California, illus- 
trated his point by telling of a woman 
who had taken a lethal dose of pills. 
She had been brought into hospital as 
an emergency and showed a determi- 
nation to die by resisting treatment. 

A volunteer on duty, a police ser- 
geant in civilian clothes, asked permis- 
sion to handle the case his own way. He 
entered the treatment room where the 
woman was confined, straddled a chair, 
and, with chin on folded arms, looked 
steadily at the woman, saying nothing. 
The woman, becoming more and more 
anxious, finally asked: "Who are you, 
and what do you want?" The quiet, 
deliberate reply: "Well, I'm from the 
coroner's office and I'm simply wait- 
ing," prompted her to scream for the 
doctor. Treatment could then begin. 

A need to communicate invariably 
characterizes the person planning sui- 
cide, continued Mr. Heilig. Figures 
from Los Angeles County, with a pop- 
ulation of 7,000,000, showed that 75 
percent of those who killed themselves 
had seen a physician within two months 
before death, and that 35 percent had 
left notes. 

Mr. Heilig said the great problem 
in communication is that of recogniz- 
ing intent. He gave an example of a 
FEBRUARY 1971 



woman who made elaborate plans to 
travel, placed her belongings in storage, 
put her affairs in order, told her friends 
about her forthcoming trip, yet remain- 
ed vague about her specific itinerary. 
She was found dead when someone 
arrived to take her to the airport. In- 
vestigation showed she had never made 
airline reservations. Where, in the 
course of her preparations for suicide, 
could she have been recognized as a 
suicidal person? he asked. 

The two-day seminar on suicide was 
organized by Patricia M. Delbridge, 
coordinator of the Ottawa Distress 
Centre. Judging from the written com- 
ments on the seminar by the trained 
volunteers who man the Ottawa Dis- 
tress Centre telephone, the high school 
counselors, the public health nurses and 
the personnel of welfare and mental 
health agencies who attended the ses- 
sions, it was a worthwhile effort. 

■New Method Used 

To Develop Curriculum 

Yarmouth, N.S. — The faculty of the 
Yarmouth Regional Hospital School 
3f Nursing, in designing a two-year 
integrated program for student nurses, 
held a special planning institute to 
investigate a new method of curriculum 
development. 

Employers of nurses, supervisors, 
and head nurses attended the three- 
day meeting in November. Robert 
'\dams, occupational training consul- 
:ant with Nova Scotia NewStart Inc., 
i research company funded by the 
provincial government, directed the 
group in identifying the skills required 
Df a graduate nurse. Three hundred 
ikills were grouped into 13 general 
areas and assembled on a large chart, 
cnown as "develop a curriculum," 
)r DACUM. The participants found 
his method of curriculum evolution 
itimulating. 

Work on the system is continuing. 
This includes the development of 
'learning activities batteries" (packages 
)f written material, audio tapes, video 
apes, anything which will help the 
rainee reach the learning objective). 
^Juch a package will be prepared for 
;ach activity on the chart and students 
will be able to progress at their own 
ate. 

Director of education at the hospital, 

ane C. Haliburton, is enthusiastic 

Ubout the process and calls it "an 

tmportant breakthrough." She said 

nquiries about the system are welcome. 

urant Helps To Finance 
tpecial Course for BC Nurses 

Vancouver, B.C. — The British Colum- 
bia Medical Services Foundation has 
warded a grant of $25,000 to the nurs- 
ing education section, division of con- 
iBRUARY 1971 



tinuing education in the health sciences. 
University of British Columbia. 

The grant will partially cover the 
cost of a special continuing education 
course for nurses in coronary and in- 
tensive care. Margaret Neylan of UBC 
is setting up the course, co-sponsored 
by the Registered Nurses' Association 
of British Columbia. The course will 
be given in 10 regions of the province 
and more than 230 nurses are eligible 
to enroll. 

A specially trained team of instruc- 
tors will travel throughout the province 
using a $4,000 teaching module donat- 
ed by Canadian General Electric Com- 
pany, containing components of a cor- 
onary care unit. The three-week course 
will be preceded by eight weeks of pre- 
paratory work by participants. 

Plans include a preliminary two- 
day course open to B.C.'s 12,000 reg- 
istered nurses to help them update 
their knowledge and skill in providing 
nursing care in respiratory and cardiac 
emergencies. 

Nursing Student Enrollment 
Increases In Province Of Quebec 

Montreal, Quebec — The first substan- 
tial increase in the number of students 
admitted to schools of nursing in the 
province since 1961 occurred in 1969, 
reports the Association of Nurses of the 
Province of Quebec's December News 
and Notes. 

There were 500 more students ad- 
mitted in 1969 for a total of 2,907. 
This number includes 77 men, the first 
year in which male nursing students 
were officially recognized. The growth 
in number of students has taken place 
in all areas of the province except 
Montreal, where the number has declin- 
ed by 200. 

The large increase in admissions 
was due to the introduction of nursing 
programs in general and vocational 
colleges, the ANPQ believes. The total 
number of students enrolled in nursing 
in all schools, hospitals, general and 
vocational colleges in 1969 was 7,388. 
Of this total, the largest group is in 
hospital schools, although this will 
change as hospital schools are phased 
out and the majority of nursing students 
will be studying in CEGEPs and uni- 
versity programs. 

National Health Grant For 
U. of T. School of Nursing 

Ottawa — A $7,021 contribution from 
the federal government's health grants 
was approved in December for the Uni- 
versity of Toronto school of nursing. 

The grant will help finance a project 
to determine the feasibility of expand- 
ing nursing services in family medical 
practice. The project will establish 
further undergraduate and postgrad- 
uate training for nurses. 




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THE CANADIAN NURSE 

% 



11 



news 



(Continued from pane 7j 

Some nurses saw the issue as an 
individual matter. Joyce Nevitt, direc- 
tor of the school of nursing at Memor- 
ial University, St. John's, Newfound- 
land, said: "There are many circum- 
stances that are personal, and more 
should be considered than the physical 
and medical sides. It's all very well for 
people to sit in judgment on whether 
or not others should have children. 
I think we ought to be more realistic. 

"I know this can be difficult for 
certain groups to accept because it's 
against their definition of when life 
begins, and I believe that's the crux 
of the whole problem. I think our 
religious overtones and beliefs stand 
in the way of our ability to be objective 
in terms of other people's needs," said 
Miss Nevitt. 

Cecile McLeary, general duty nurse 
on the gynecological unit at the Univer- 
sity Hospital in Saskatoon, Saskatche- 
wan, said, "If a woman does not want 
to continue with an unwanted pregnan- 
cy, then she should not have to; other- 
wise, we force her to have an unwanted 
child." 

Another nurse who believes abor- 
tion should be an individual decision 
is Lois Good, clinical instructor, Cha- 
leur General Hospital, Bathurst, New 
Brunswick. But in meeting the needs 
of the individual, she would not want 
to see abortion done "wholesale." She 
also favors a committee system, but 
would like it to become more consulta- 
tive. "Some pregnancies need not be 
terminated if other avenues are explored 
and social help given to the woman 
and family; but if the outlook is bleak, 
this is another story. 

"If a woman has strong feelings 
about abortion, she's going to have 
one whether it's self-induced or other- 
wise. We also should be doing some- 
thing about getting family planning 
across to the public," she said. 

Miss Good conducted her own poll 
on the issue, consulting 18 students 
and staff members at the hospital. Ten 
nurses approved the CPA statement, 
five approved with qualifications, and 
three said, definitely not, on religious 
grounds. 

"Abortion should be a person's own 
decision, with her doctor to advise 
her medically," said Pauline Shaw, 
medical-surgical supervisor, Prmce 
County Hospital, Summerside, Prince 
Edward Island. "The individuals in- 
volved have to cope with the problem. 
The doctors on the committee are mak- 
12 THE CANADIAN NURSE 



ing a decision on someone else's prob- 
lem. And in no way should abortion 
be a criminal offense," she added. 

Emphasizing family planning, Doro- 
thy Mumby, director of public health 
nursing, London, Ontario, said, "Un- 
wanted pregnancies should not happen 
if contraception and methods of family 
planning are readily available. I would 
not want to see abortion for abortion's 
sake or people not using contraceptive 
measures, but I don't think abortion 
should be a criminal matter. It becomes 
a question of not pressing our own 
moral beliefs on other people." 

The nurses interviewed agreed that 
the Canadian Nurses' Association 
should take a stand that abortion be 
removed from the Criminal Code. 
"I think Canadian nurses should take 
a stand," said Miss Good. One nurse 
thought all members should be polled 
and a majority opinion published. Mrs. 
McLeary said, "Nurses work closely 
with doctors in this and while legally 
we are not affected, I think we should 
follow the lead of the medical profes- 
sion." 

Sister Castonguay said, "I think it is 
important that CNA speak out. Up to 
the present, nurses have been involved 
in problems within the profession. I 
think it's time we got involved in social 
issues." She also believes a nurse should 
not be forced to assist in abortion 
procedures when it is against her cons- 
cience. "But a nurse should not impose 
her views on the patient, "she said. 

Miss Giles said, "A realistic, res- 
ponsible decision and a public state- 
ment on this multi-faceted problem 
is long overdue. We must as individual 
members come to terms with our beliefs 
and feelings and confront this issue by 
a decision through our organization. 

"How long can we continue to ig- 
nore the desperate plea of a woman 
seeking an abortion? How long can we 
negate the word health in relation to 
abortion, considering the devastating 
effects of unwanted pregnancy on the 
woman, her child, her husband, and 
her family?" asked Miss Giles. 

Mrs. Mumby said nurses sould take 
a stand because "nurses are part of the 
whole health complex. Abortion is a 
question of health, not of legal effect 
on the individual." Seconding that 
opinion was Mrs. Burwell, who added, 
"It is an ethical problem too. But are 
we taking the right ethical stand in 
forcing people to have unwanted chil- 
dren?" 

"Nurses can't very well stand on the 
sidelines saying i believe this or that,' " 
said Miss Nevitt, "We ought to remem- 
ber that we serve people and we are 
members of a 'caring' profession. We 
don't have to condone everything pa- 
tients do, but we must care about 
them," she added. 



Days Of Pill-Pushing Nurse 
Are Numbered 

London. Ont. — The nurse can no 
longer be a "pill pusher," but must 
expand her role to that of practitioner 
and educator, more than 150 nurses 
from London and district were told at 
an October seminar on new trends in 
drug distribution systems and the role 
of the clinical pharmacist. 

Both nurse and pharmacist have a 
goal of better patient care, and studies 
have shown they would use similar 
methods to reach this goal. Methods 
include improving communication be- 
tween the departments of nursing and 
pharmacy, utilizing the pharmacist on 
the nursing unit, and a more compre- 
hensive drug administration system to 
patients. 

The nursing staff would be freed 
from the non-nursing function of med- 
ications, that is, ordering, checking 
stocks, and processing medication or- 
ders. Nurses would be involved in 
more therapeutic areas, such as teach- 
ing patients about drugs and their ef- 
fects prior to discharge. 

Guest speakers were Dr. F.S. Brien, 
chief of medicine, Victoria Hospital, 
London; B. Dinel. director of pharmacy 
services. University Hospital, London; 
Dr. W.M. McLean, director, pharma- 
ceutical services, St. Joseph's Hospital, 
Guelph; J. Parks, assistant director, 
pharmaceutical services, Victoria Hos- 
pital, and H. Smythe, director of phar- 
macy services, Ottawa Civic Hospital. 

The seminar was sponsored by the 
committee for continuing education 
for professional nurses, London. 

RNAO, OHA, OMA Sponsor 
Courses In Coronary Nursing 

Toronto, Ont. — Four clinical courses 
in coronary care nursing, endorsed by 
the Ontario Hospital Association, the 
Ontario Medical Association, and the 
Registered Nurses' Association of 
Ontario, will be offered in 1971 by the 
University of Toronto through its 
continuing education program for 
nurses. 

Four consecutive four-week courses 
will be conducted between mid-April 
and the end of August, 1971. Addition- 
al courses are planned for 1972. 

The purpose of the program in cor- 
onary care nursing is to prepare regis- 
tered nurses to function effectively as 
staff nurses in coronary care units. 
Each post-diploma course will include 
supervised clinical experience within 
coronary care units of six hospitals in 
the Toronto area. 

Guidelines for post-diploma pro- 
grams, prepared by the Registered 
Nurses' Association of Ontario's work- 
ing party on continuing education in 
(Continued on page 14) 
FEBRUARY 1971 



i 




This decongestant tablet contends that a 
cold is not as simple as it seems on television 



Coricidin* "D" tablets 
shrink swollen mem- 
branes with the best of 
them (note the 10 mg. of 
phenylephrine). 

Unfortunately, the mis- 
ery of a cold doesn't end 
with unblocl<ed passages. 

That's why Coricidin "D" 
also contains two anti- 
pyretic and analgesic 
agents. They cool down 
the steaming fever and 
suppress the aches and 



pains that go with the 
adult cold. 

That's why we also help 
perk up sagging spirits 
with 30 mg. Caffeine. 
And why we also include 
2 mg. of Chlor-Tripolon* 
to combat rhinorrhea . . . 
and strike out at the very 
root of congestion. 
Know of another cold 
reliever that gives your 
patient so many helpful 
also's? 

Coricidin "D" 

comprehensive relief 

of cold svmntom.'i 



DESCRIPTION: Each CORICIDIN 
■ D" tablet contains 2 mg. 
CHLOR-TRIPOLON- (chlorpheni- 
ramine maleate). 230 mg. acetyl- 
salicylic acid, 160 mg. phena- 
cetin. 30 mg. caffeine, 10 mg. 
phenylephrine, 

DOSAGE: Adults: one tablet 
every 4 hours, not to exceed 4 
tablets in 24 hours. Children (10- 
14 years): Vi the adult dose. 
Children under 10 years: as di- 
rected by the physician. 



SIDE EFFECTS: Adverse reac- 
tions ordinarily associated with 
antihistamines, such as drowsi- 
ness, nausea and dizziness occur 
infrequently with Coricidin "D" 
when administration does not 
exceed recommended dosage. 
PRECAUTIONS: IVIay be injurious 
if taken in large doses or for a 
long time. Additional clinical 
data available on request. 

'reg. Trade l^arl<. 



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For colds of all ages: 
Coricidin tablets, 
Coricidin with Codeine, 
Coriforte for severe colds, 
Nasal Mist, Medilets 
and Coricidin "D" tVledilets 
for children. 
Pediatric Drops, 
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and Lozenges. 



news 



(Continued from page 12 1 

coronary care nursing in cooperation 
with the OHA, OMA, and other allied 
groups, will be used to develop the 
program. An advisory committee for 
the project will include representatives 
from nursing, medicine, non-teaching 
hospitals, and the three endorsing 
associations. Much of the groundwork 
for the courses was done by Lucille 
Peszat, coordinator of RNAO's con- 
tinuing education department. 

Preference will be given to sponsored 
candidates, although applications from 
other nurses are invited. Requests for 
further information and application 
forms may be directed to Marian I. 
Barter, director, continuing education 
program for nurses, School of Nurs- 
ing, University of Toronto, 47 Queen's 
Park Crescent, Toronto 5, Ontario. 

Canadian Soldiers In Cyprus 
Help Crippled Children 

Kyrenia, Cyprus — Since they arrived 
with the United Nations Peacekeeping 
Force in Cyprus in 1966, Canadian 
soldiers have donated $8,250 to the 
Kyrenia Red Cross Crippled Children's 
Hospital. 

In September, the First Battalion, 
the Royal Canadian Regiment of Lon- 
don, Ontario, donated $1,500 to the 
hospital. In addition to financial aid, 
the soldiers have made repairs and 
improvements to existing facilities 
and provided medical supplies, as well 
as showing weekly films to children. 

Federal Grant Approved 
For McMaster Project 

Ottawa — A federal government grant 
of $8,380 has been approved for a 
McMaster University study project. 

The grant was made through the 
health grants program of the depart- 
ment of national health and welfare 
and announced in December. It will 
help finance a project to study the vary- 
ing responsibilities of nurses employed 
in different medical practices such as 
hospitals, private physicians' offices, 
and family practice units. 

Initially, the project will involve 
collection of data on nursing activities. 
A survey of patients in each practice 
will determine acceptance of present 
nursing services and the projected 
acceptance of other services that might 
be carried out by nurses. Future phases 
of the project will involve educational 
programs for nurses and possible mod- 
ification of training courses. 

14 THE CANADIAN NURSE 




I ^.^^OKtitm^^Jm^ 



wo H.E.G. Baxter of London, Ontario, and Cpl. E.W. Page of Hamilton, 
Ontario, help Red Cross nurses serve refreshments to children at the Crippled 
Children's Hospital in Kyrenia, Cyprus. During this party the hospital received 
a $ 1 ,500 cheque from the First Battalion, Royal Canadian Regiment. 



Unions Sponsor Health Center 
For The Capital Area 

Ottawa — Plans are underway for 
the development of a prepaid group 
practice health center for the Ottawa 
area. Backing the health center are the 
Ottawa-Hull Area Council of the Public 
Service Alliance of Canada, the Ottawa 
District Labour Council, Council of 
Postal Unions, and the Council of 
Graphic Arts Unions. 

To be called the Ottawa and Dis- 
trict Community Group Health Founda- 
tion, it will be established as a non- 
profit corporation to provide a facility 
and program for comprehensive health 
care for its subscribers. As part of the 
raising of capital funds for the building 
and equipment, subscribers will pay 
an assessed sum by payroll deductions 
over a three-year period. At two similar 
health centers in Ontario, Sault Ste. 
Marie and St. Catharines, the fee was 
$150 per family. 

The operating costs of the health 
center will be met through regular 
OHSIP premiums. Arrangements will 
be made to permit residents of Quebec 
to use the health center. 

The group practice will be designed 
to provide general and specialist medi- 
cal care as well as other health services 
to provide a comprehensive health care 



program for all members of the family. 
Personal physician services, prenatal 
and obstetrical services, pediatric care, 
annual check-ups, doctors' office, hos- 
pital and home visits, eye examinations, 
and surgery, along with the necessary 
laboratory work, blood tests, x-rays 
and physiotherapy, are included in the 
center's plan. 

Subscribers will select a personal 
physician from among the family phys- 
icians at the center. He will work with 
the family to meet the health care needs 
of the family. Specialists from the 
center and outside will be consulted. 

The center acts as a clearing-house 
for patients' calls. Appointments with 
the physicians will be available Monday 
through Saturday. Emergency and 
urgent care clinics will be held evenings 
and weekends. At other hours a phy- 
sician will be reached for emergency 
care and advice by calling the center. 

Recently, the Federal Task Force 
on the Costs of Health Services, the 
Ontario Committee on the Healing 
Arts, several committees of the Ontario 
Council of Health, and the Economic 
Council of Canada reported favorably 
on the concept of community health 
centers. ^ 



FEBRUARY 1971 



names 



Fanny Annette (Nan) Kennedy (R.N., 
The Vancouver General Hospital 
School of Nursing; dipl. public health 
nursing, U.B.C.; B.Sc.N., U.B.C.; 
M.A., U. of Washington, Seattle) has 
been appointed executive director of 
the Registered Nurses' Association of 
British Columbia, a post she has filled 
on an interim basis from September to 
December of last year. 

Miss Kennedy joined the RNABC 
in 1959 as educational consultant. Her 
writing talents were put to use in the 
association's 1962 brief to the Royal 
Commission on Health Services and in 
its 1967 proposed plan for the orderly 
development of nursing education in 
British Columbia. 

Prior to her work with the RNABC, 
her interest in public health had 
brought her as far afield as Dacca, 
East Pakistan and Teheran, Iran, under 
the auspices of the World Health Or- 
ganization. 

Sister Shirley Crozier (R. N., St. Ma- 

rv's School of Nursing, Sault Ste. Marie; 
B.Sc.N., and M.H.A., U. of Ottawa) 
was appointed administrator of the 
General Hospital, Sault Ste. Marie, 
Ontario. Sister Crozier served as super- 
visor, director of nursing services and 
education, and assistant administrator 
before studying hospital adminstration. 
On accepting her new appointment 
to replace Sister Teresa Agatha who 
resigned for health reasons. Sister Cro- 
zier said, "Generally, it is inevitable 
there will be a change in the trends. I 
could sec this and realized 1 should 
continue my education. Hospitals are 
becoming more community oriented 
and more services are being amalgamat- 
ed. The health field is developing rap- 
idly and each five years makes a dif- 
ference." 

Joyce Nevltl, director. School of Nurs- 
ing. Memorial University of Newfound- 
land. St. John's, was elected president 

of the Newfoundland branch of the 
Canadian Public Health Association 
at its November meeting in St. John's. 
Elizabeth R. Summers, past president of 
the Association of Registered Nurses of 
Newfoundland, was elected councillor. 

The Association of Registered Nurses 
of Newfoundland, at its October meet- 
ing, elected the following: president, 
Phyllis Barrett; president-elect, Elizabeth 

FEBRUARY 1971 




Wilton; immediate past president, Eliz- 
abeth Summers; past president. Rev. 
Sister Catherine Kenny; 1st vice-presi- 
dent, Joyce Nevitt; 2nd vice-president, 
Elsie Hill. 

Mrs. Barrett (R.N., 
General Hospital 
School of Nursing, 
St. John's Nfld.; 
Dipl. Nursing Edu- 
cation and Admin., 
U. of Toronto; B.N. , 
Memorial U. of 
Newfoundland), 
president of the 
ARNN, has had experience in nursing 
education and admmistration, public 
health and outpost hospital nursing, 
and as assistant executive secretary of 
the ARNN. Recently she has been guest 
lecturer at the St. Clare's Mercy Hos- 
pital and the Salvation Army Grace 
General Hospital Schools of Nursing, 
St. John's, Nfld. 

Elsie K. Di Blasio 

(Reg.N., General 
Hosp., Port Arthur 
School ol Nursing; 
B.Sc.N., Lakehead 
U., Thunder Bay) 
has been appointed 
curriculum coord- 
inator at the Lake- 
h e a d Regional 
School o\' Nursing, Thunder Bay. On- 
tario. She will be responsible for coord- 
inating the first and second year of the 
twxi-plus-one diploma program. This 
will include making arrangements for 
clinical experience in the hospitals and 
community agencies. 

Prior to this, Mrs. Di Blasio has had 
experience as staff nurse, assistant 
head nurse, and as a teacher with all 
levels of students at the General Hos- 
pital of Port Arthur School of Nursing. 
She participated in the development 
of the first- and second-year program 
ot the Lakehead Regional School of 
Nursing and taught in the classroom 
and clinical area. Mrs. Di Blasio has 
been active at chapter level of the Re- 
gistered Nurses' Association of Ontario 
as secretary and committee chairman. 

Elsie Mary Taylor (S.R.N.. St. George- 
in-the-East Hospital. London, England 
and St. Alfeges H., Greenwich, London, 
England; Dipl., teaching and super- 
vision. U. of British Columbia, Van- 





couver) IS the new director ot nursing 
at the Kitiniat General Hospital, Miss 
Taylor has been matron at a mission 
hospital in Biafra prior to which she 
was on staff at the Royal Jubilee Hos- 
pital. Victoria. B.C. 

Correction 

Oops! We slipped in the December 
issue of The Canadian Nurse: a column 
full of Faculty members got misplaced. 
The following, mentioned on page 19, 
are all members of the staff of the 
School of Nursing, Dalhousie Univer- 
sity, Halifax: Muriel E. Small, Jo-Ann 
(Tippett) Fox, Margaret ArkJie, Eve- 
lyn Joyce Carver, Judith (H a 1 1 i e) 
Cowan, Margaret Rose Matheson, 
Nancy Elizabeth Riggs, Linda Rob- 
inson. 

Joan Baetz (Reg.N., 
Kitchener-Waterloo 
Hospital School of 
Nursing), formerly 
on the staff of 
/-Jk V Kitchener-Waterloo 
Hospital, has ar- 
rived in Afghanis- 
tan to serve a two- 
!'»... year tour of duty 
with MEDICO, a service of CARE. 

Miss Baetz. working with a 10-mem- 
ber MEDICO team of doctdrs, nurses 
and a technologist stationed at Avicen- 
na Hospital in the Afghan capital of 
Kabul, will treat patients and help train 
counterpart personnel. 

Sally A. Pearson 

(Reg. N., Civic Hos- 
pital School of Nurs- 
ing, Peterborough, 
Ont.; Dipl. teaching 
in schools of nurs- 
ing, Dalhousie U.. 
Halifax) has been 
'"^ appointed director 

of patient care ser- 
vices of the Kootenay Lake General 
Hospital, Nelson, B.C. Miss Pearson's 
nursing career has taken her to Chapel 
Hill, N.C., where she worked at Mem- 
orial Hospital, University of North 
Carolina; to Los Angeles, California, 
where she became assistant director 
of nursing at the Shriners Hospital for 
Crippled Children, and to West Covina. 
California, where she was a supervisor 
at the Queen of the Valley Hospital. 
Prior to her present appointment. Miss 
Pearson was instructor at St. Mary's 
School of Nursing in Kitchener, Ont. 

THE CANADIAN NURSE 15 




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NURSING 
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self-sticking quality of Time Nursing 
Labels eliminates the need for hand 
to mouth contact while working with 
patient record. 

More efficient because Time Nursing 
Labels provide you with an effective 
system of identification and communi- 
cation within and between departments. 

Time Patient Chart Labels color-code 
your charts and records in any of 17 
colors with space for all pertinent pa- 
tient Information. 

Time Chart Legend Labels alert busy 
personnel to important patient care 
divertives eliminating the possibility of 
error through verbal instructions. 

There are many other Time Labels to 
assist you in speeding your work and 
to assure accuracy in important pa- 
tient procedures. Write today for a 
free catalog of all Time Nursing Labels. 
We will also send you the name of 
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16 THE CANADIAN NURSE 




V 4. 



D.A. Mills 



B. Mibu 



Norma A. Wylie, director of nursing 
at the McMaster University Medical 
Centre, has announced the appoint- 
ment of four nurses to assist in explor- 
ing and developing the expanded role 
of the nurse in medical services. 

Working in the family Health Care 
Centre, where a facility for family care 
is to be provided, will be: 
Dorothy-Anne Mills 1 (Reg. N., St. Jo- 
seph's H. School of Nursing, London, 
Ont.; Dipl. Public Health Nursing, U. 
of Western Ontario, London; B.N. in 
public health, McGill U., Montreal), 
who has been employed in public health 
in Ottawa, London, and the Peel Coun- 
ty Health Unit. 

Barbara Milne (Reg. N., St. Josephs 
School of Nursing, Hamilton; B.Sc.N., 
U. of Toronto School of Nursing), who 
has been nurse supervisor at the School 
for the Deaf, Milton, has done child 
protection work with the Children's 
Aid Society and clinical teaching at 
The Hospital for Sick Children, Toron- 
to, Ontario. 

Anna Loughlin (Reg. N., Hamilton 
Civic Hospitals School of Nursing, 
Hamilton; B.Sc.N., U. of T o r o n t o 
School of Nursing), who has been 
instructor at the Hamilton Civic Hos- 
pitals School of Nursing and has had 
experience as staff nurse and supervisor 
in the areas of intensive care, coronary 
care, and surgical nursing. 
Linda, Clark (B.S.c.N., McMaster U. 
School of Nursing), who worked in a 
psychiatric unit affiliated with the 
department of psychiatry at McMaster 
University prior to her present ap- 
pointment. 



Helen M. Carpenter (B.S., M.P.H., 
Ed.D.) was awarded an honorary mem- 
bership in the Canadian Red Cross 
Society in recognition of her many 
years of outstanding and dedicated vo- 
luntary service. 

Dr. Carpenter is chairman of the 
nursing advisory committee and a vice- 
chairman of the health, emergency and^ 
welfare committee of the Canadian Red 
Cross Society. 

Presentation of the award was made 
by Brigadier Ian S. Johnston, presi- 
dent of the Canadian Red Cross at a 
meeting held in Toronto November 23 
and 24. 

Elizabeth K. McCann, acting director. 
School of Nursing, University of Brit- 
ish Columbia, has succeeded Margaret 
G. McPhedran, director. School of 
Nursing, University of New Brunswick, 
as president of the Canadian Confer- 
ence of University Schools of Nursing 
(CCUSN). 

An error was made on page 22 of the 
November 1 970 issue of The Canadian 
NL4rse. The correction follows. 



A. Loughlin 



L. Chirk 




M.H. Davidson 



Muriel H. Davidson (Reg.N., Toronto 
General Hospital School of Nursing; 
cert, public health nursing, dipl. ad- 
ministration and supervision, B.Sc.N., 
U. of Toronto) is the first director of 
health services for George Brown Col- 
lege of Applied Arts and Technology, 
Toronto. With 12 public health nurses 
on her staff, some on a part-time basis, 
Miss Davidson is responsible for health 
services for close to 7,000 students at 
the six Toronto campuses of the col- 
lege. She had for 21 years been a pub- 
lic health nurse with the Ontario de- 
partment of public health, Toronto 
office. 

Madeleine Celia Smillie (Reg. N., 
B.Sc.N., U. of Toronto; M.P.H., U. 
of Michigan, Ann Arbor) has been 
assistant director of the nursing divi- 
sion, Toronto department of public 
health, since September 1969. She has 
brought a detailed knowledge of nursing 
service to her present position as she 
has been with the department ail her 
professional life — as staff nurse, assist- 
ant supervisor, and district supervisor. 
FEBRUARY 1971 




Next 

to your 

face 

the most comfortable 

thing is a new 

SURGINE" 

mas[< 



»s ^ 




Johnson & Johnson's newly developed SURGINE Face 
Mask — six years in the designing — is so extra- 
ordinarily comfortable you'll be almost as unaware of 
it as you are of your own skin. 

The fact that the SURGINE mask fits so well is part of the 
reason it does such a superior job of bacterial filtration. 
Cheek and chin leaks are eliminated. But the main 



reason for SURGINE's efficiency is a new, specially 
developed filter medium. In vivo tests show an extra- 
ordinary average filtration efficiency of 97%. 
For free samples of the new SURGINE Face Mask, con- 
tact your Johnson & Johnson representative. Or write to 
Mr. Mark Murphy, Product Director, Johnson & Johnson 
Ltd., 2155 Blvd. Pie IX, Montreal 403, Quebec. 

'Trademark of Johnson & Johnson or affiliated companies. 



SURGINE 

the comfortable face mask 

MONTREALATORONTO- CANADA 



FEBRUARY 1971 



THE CANAD^N NURSE 17 



new products 



Descriptions are based on information 
supplied by the manufacturer. No 
endorsement is intended. 



Daisy Electrodes and GE-Jel 

General Electric's new "daisy" elec- 
trodes and GE-Jel electrode paste, 
used together, improve the monitoring 
fidelity of any patient monitoring sys 
tern regardless of equipment used. 

These electrodes, combining silver 
and silver chloride, produce a very 
slight offset potential. This means the 
observed signal on the monitor will 
normally move very little when select 
ing different "lead"' positions. The rate 
of change of the offset potential is 
similarly reduced, providing a stable 
baseline lor patients monitored over 
long periods. The waveform trace is 
accurate, stable, sharp, and clear. 

GE-Jel electrode paste allows high 
conductivity with minimal skin irrita- 
tion, and can be used for cxtcndetl 
periods of time without drying out. 

GE "daisy" electrodes and GE-Jel 
paste, when used together, eliminate 
the need for frequent and time-con- 
suming electrode changes. Patient com- 
fort is increased and monitoring ciists 
reduced. 

hor more information, write Gen- 
eral Electric Company. 3."^ I I Bayview 
Ave., Medical Systems Department, 
Toronto, Ontario. 



Capastat — Anti-TB Drug 

After seven years of clinical trials 
conducted by physicians across Canada 
and research dating back to 1956, 
Capastat (capreomycin sulphate, Lilly) 
has become available in Canada. As 
Capastat has not shown cross-resistance 
with primary anti -tuberculosis drugs, 
it has achieved wide acceptance in both 
original and retreatment cases. 

Worldwide experience has shown 
that Capastat can play an important 
and sometimes life-saving role in the 
treatment of patients who have become 
resistant to other available agents. 

With the problem of drug resistance 
and drug intolerance on the increase, 
an effective, well -tolerated, and cur- 
rently distinct antibiotic such as 
Capastat may be of significant help in 
the treatment of many tuberculosis 
patients. 

Presently marketed in 42 countries 
around the world, Capastat is distrib- 
uted in Canada by Eli Lilly and Com- 
pany (Canada) Limited from their plant 
at 3650 Danforth Avenue, Scarborough, 
Ontario. 

18 THE CANADIAN NURSE 




Daisy Electrodes and GE-Jel 



Sinequan for Anxiety and Depression 

Introduced by Pfizer Company Ltd.. 
Sinequan (doxepin HCL), can be used 
for the treatment of patients with anx- 
iety or depression if they exist alone, 
or both when they exist together, as 
is usually the case. The Canadian hood 
and Drug Directorate has approved 
Sinequan as "'antidepressant and anx- 
iolytic" as it offers potent antianxiety 
and antidepressant action in a single 
chemical compound. 

Sinequan is well tolerated by most 
patients, including the elderly. Espe- 
cially gratifying is the fact that Sine- 
quan does not appear to cause habitua- 
tion and dependence, even after pro- 
longed use. Drowsmess and anticholi- 



nergic side effects, such as dry mouth 
and constipation, may sometimes occur. 
Cardiovascular effects, such as tachy- 
cardia and hypotension, have been 
reported infrequently. Some of these 
side effects tend to subside with con- 
tinued therapy or reduction of dose. 

Available initially in 10 mg.. 25 mg., 
and 50 mg. capsules, the usual dose 
of Sinequan is 75 mg. per day. Some 
patients with mild illnesses have been 
treated successfully with doses as low 
as 25 mg. to 50 mg. daily. In more 
severely-ill patients, dosage as high 
as 300 mg. daily can be employed. 

hurther information may be obtained 
from the Pfizer Company Ltd., 50 
Place Cremazie, Montreal 35 1 , Que. 

FEBRUARY 1971 



New Examining Table 

A new examining table, called the 
"Vista I," has been designed and built 
in Canada for the J.F. Hartz Company. 
The contoured, foam-padded top is 
adjustable to any position between 
horizontal and vertical for patient com- 
fort. Leg rest and heavy duty, brushed, 
chrome stirrups are stored out of sight 
when not in use. 

A double electrical outlet, pull-out 
instrument table, recessed paper holder, 
and two handy drawers with seamless 
heavy duty liners are additional fea- 
tures. The walnut finished table has two 
spacious storage cabinets matching the 
top of green, blue, white or tan. 

The table is available from the J.F. 
Hartz Company Limited, 34 Metro- 
politan Road, Scarborough and its 
sales and distribution centers across 
Canada. 



Influenza Virus Vaccine 

M.T.C. Pharmaceuticals Limited, a 
subsidiary of Canada Packers Limited, 
has been appointed distributor of the 
biological products of The Institute 
of Microbiology and Hygiene. Uni- 
versity of Montreal. 

In October. M.T.C. Pharmaceuti- 
cals introduced the new improved In- 
fluenza Virus Vaccine bivalent (types 
A2 t^ B) that includes highly antigenic 
strains of influenza virus isolated by 
the Institute. 

Developed by the Institute two years 
ago, Inlluenza Virus-Vaccine bivalent 
(types A2 and B) is the only influenza 
vaccine manufactured in Canada. It is 
distributed in packages containing one 
vial of 10 cc. or 10 doses. Each cc. of 
this bivalent vaccine contains a total 
of at least 600 units CCA as follows 
Strains Type A2/Aichi/2/6S. Hong 
Kong variety, 200 Units CCA; Type 
A2/Montreal/68. 100 Units CCA; 
and Tvpe B/Massachusetts/3/66. 300 
Units CCA. 

The vaccine can be administered 
to all individuals in good health. It is 
of particular importance for elderly 
people, very young children, individ- 
uals suflering from heart disease or 
other chronic disease, as well as for 
personnel of essential services, such as 
hospitals, public health, armed forces, 
transportation, police and tire depart- 
ments. 

For good immunization, two doses 
of I cc. of Inlluenza Virus-Vaccine, 
with an interval of two to four weeks 
between each dose, are recommended 
for adults and children over 12 years 
of age. I or children under 12 years of 
age, doses of 0.5 cc, and proportion- 
ately less for infants, should be admin- 
istered. 

I urther information may be obtained 
from M.T.C. Pharmaceuticals Ltd.. 

FEBRUARY 1971 




^43 Marie-Victorin. Duvernay. Laval. 
P.O.; 1X90 Brampton St.. Hamilton. 
Ontario; or Box 3030. Calgary. Al- 
berta. 



Soframycin Unitulle 

Soframycin Unitulle is a lightweight 
lano-paraffin sterile gauze dressing 
impregnated with one percent Sofra- 
mycin (framycetin sulphate). 

In an outer paper envelope carrying 
comprehensive instructions for use. 
each sterile tulle antibiotic dressing 
measuring 10 cm x 10 cm is protected 
by an individual packaging consisting 
of a piece of parchment supporting the 
tulle on each side, thus facilitating 
handling, shaping, and application and 
a scaled foil sachet ensuring sterility 
and stability. 

Impregnated with a non-systemic 
broad spectrum antibiotic, it rapidly 
eradicates wound infection; is not in- 
activated by blood, pus. or serum; 
affords excellent physical protection; 
does not adhere to granulating tissue; 
docs not produce maceration; is easy 
to handle and apply. Sterility and stabil- 
ity are assured at all times, and it is 
economical to use. 

Soframycin Unitulle may be used for 
burns and scalds; lacerations, abra- 
sions, bites, puncture wounds, and 
crush injuries; varicose, diabetic, decu- 
bitus, and tropical ulcers; skin grafts 
(tlonor and receptor sites); avulsion of 
linger and/or toe nails; circumcision; 
suture lines; etcetera. 

When dressing ulcers, the tulle should 
be shaped to fit the ulcer crater, thus 
minimizing any potential risk of sensi- 



Examining Table 

tization due to contact with the sur- 
rounding epidermis. If the lesion 
exudes profusely, it is advisable to 
change the dressing at least once a 
day. 

In patients known to be allergic to 
Streptomyces-derived antibiotics (neo- 
mycin, paramomycin. kanamycin), 
cross sensitization to Soframycin may 
occur, but not invariably so. In most 
cases absorption of the antibiotic 
is negligible. However, where large 
body areas are involved, e.g., 30 per- 
cent or more body burn, the possibility 
of ototoxicity being produced by pro- 
longed applications should be borne in 
mind. 

Available in cartons of 10 units, 
each unit pack contains one sterile 
antibiotic gauze dressing 10 cm x 10 
cm. 

Enquiries regarding Soframycin 
Unitulle may be addressed to the manu- 
facturer. Roussel (Canada) Ltd.. 2795 
Bates Road. Montreal 25 1, Quebec. 



Plexitube Line Adds 
Twenty-Two New Items 
Baxter Laboratories of Canada has 
expanded its line of Plexitube tubes 
and catheters with the recent addi- 
tion of 22 individual new items. 

The additions, varying in gauge and 
size, represent six basic families of 
tubes and catheters, which include 
Levin stomach tubes, nasal oxygen 
catheters and connecting lubes, feed- 
ing tubes, suction catheters, general 
iConliniicct on piii;e 21 ) 

THE CANADIAN NURSE 19 



Fleet 

ends ordeal by 

Enema 

for you and 
your patient 




Now in 3 disposable forms: 

• Adult (green protective cap) 

• Pediatric (blue protective cap] 

• Mineral Oil (orange protective cap) 

Fleet — the 40-second Enema * — is pre-lubricated, pre-mixed, 
pre-measured, individually-packed, ready-to-use, and disposable. 
Ordeal by enema-can is over! 

Quick, clean, modern, FLEET ENEMA will save you an average of 
27 minutes per patient — and a world of trouble. 

WARNING: Not to be used when nausea. In dehydrated or debilitated 

vomiting or abdominal pain is present. patients, the volume must be carefully 

Frequent or prolonged use may result in determined since the solution is hypertonic 

dependence. and may lead to further dehydration. Care 

CAUTION: DO NOT ADMINISTER should also be taken to ensure that the 

TO CHILDREN UNDER TWO YEARS contents of the bovirel are expelled after 

OF AGE EXCEPT ON THE ADVICE administration. Repeated administration 

OF A PHYSICIAN. at short intervals should be avoided. 

Full information on request. 



/e\l 



t PHARMACEUTICALS 



•Kehlmann, W. H.: Mod. Hosp. 84:104, 1955 /*V--^aa;ife4£.3iu>»t&Co. 

/ ^m^^ KWKLANO (MONT(C*LJ CANADA ^ 

FLEET ENEMA® — single-dose disposable unit / ^^ 



fOiltOCD m CAMAOA » 



20 THE CANADIAN NURSE FEBRUARY 1971 



new products 



(Continued from page 19) 

purpose connecting tubes, and urethral 

catheters. 

The tubes and plastic catheters are 
made of clear polyvinyl, the Foley 
catheters, of soft latex. The beveled 
eyes and tips prevent tissue irritation, 
and bold markings clearly indicate 
insertion depths. Thin-wall design 
permits a small outside diameter with- 
out sacrificing inside diameter. 

Connectors for females, made of 
flexible gum rubber, will fit the wide 
variety of connectors found in hospitals. 
Connectors for males lit around the 
tube to prevent reduction of lumen size. 

Plexitube tubes and catheters are 
odorless, tasteless, and non-toxic. 
Transparent Pell-Pack packaging af- 
fords easy visual identification of 
contents and aseptic dispensing. 

For additional information write 
Director of Marketing. Baxter Labor- 
atories of Canada. 640,^ Northam 
Drive. Malton. Ontario. 

Literature Available 

Defense Against Decubitus Ulcers: 
The Conquest of the Hidden Epidemic, 
a comprehensive, 12-page booklet, 
has been issued by Alconox, Inc. Direct- 
ed to nurses, nurses aides, adminis- 
trative and personnel training staff of 
health care institutions, it details the 
causes, symptoms and prophylaxis or 
prevention of decubitus ulcers. 

The booklet describes the use of 
topical applications, pressure-relieving 
materials, and mentions the relative 
merits of aerosol spray versus cream 
for topical applications, and natural 
sheepskins or shearlings versus synthetic 
fibers as pressure-relieving materials. 

The preventive program presented 
in the booklet is designed for convenient 





Patient-Proof Safety Belt Clip 



inclusion in an institution's regular 
program of total patient care. 

The special appendix includes a 
suggested pocket-sized directive manual 
for nurses and aides that outlines a 
seven-point action program, and illus- 
trates the body's 10 pressure points 
most prone to decubitus ulcers. A bed- 
side form with nursing directions and 
record chart for position change is 
included. 



MOVING? 
BEING MARRIED? 

Be sure to notify us six weeks in advance, 
otherwise you will likely miss copies. 



> 



Attacfi the Label 
From Your Last Issue 

OR 
Copy Address and Code 
Numbers From It Here 



< 



NEW (NAME) /ADDRESS: 



Street 



City 



Zone 



Decubitus Ulcer Literature 
FEBRUARY 1971 



Prov. /State Zip 

Please complete appropriate category; 

I I I hold active membership in provincial 
nurses' assoc. 



reg. no./perm. cert./ lie. no. 

I I I am a Personal Subscriber. 

MAIL TO: 

The Canadian Nurse 

50 The Driveway 
OTTAWA 4, Canada 



For a free copy of Defense Against 
Decubitus Ulcers: The Conquest of the 
Hidden Epidemic, write to Alconox, 
Inc., 215 Park Avenue South, New 
York, N.Y. 10003. 



Patient-Proof Safety Belt Clip 

A new safety belt security slip has 
been introduced by the Posey Company. 
This device prevents a patient from 
untying the Posey belts or wristlets that 
keep him from getting out of or falling 
from his bed or wheelchair. 

Designated the Poseyclip, this spring 
steel item can be used on virtually all 
Posey safety devices and fits all web- 
bing up to two inches wide. 

The Poseyclip is easily attached to 
or removed from Posey safety belts 
and vests by the nurse, yet is essentially 
impossible for the patient to remove. 

The new Poseyclip, Cat. No. 8150, 
is obtainable in Canada through Enns 
& Gilmore Ltd., Port Credit, Ontario. 

New Medical Headlight 

An improved medical headlight has 
been developed by Welch Allyn. It is 
fitted with a high-intensity quartz- 
halogen lamp, permitting constant light 
intensity without dimming during the 
life of the lamp. Additional advantages 
of the quartz halogen lamp are the 
absence of filament shadows and pre- 
servation of natural tissue colors. 

A built-in iris diaphragm provides 
a spot adjustable from 1 V2 " to 6" dia- 
meter at 14" distance. The level of 
illumination is uniform through this 
iris diaphragm regardless of spot size. 

For complete information write the 
J.F. Hartz Company Limited, 34 Me- 
tropolitan Road, Scarborough, Ontario 
or any Hartz sales and distribution cen- 
ter in Canada. 'i3' 
THE CANADIAN NURSE 21 



0| 



There's one difference 

"It's only a hazard if you're a female," 
said a nursing sister during a press 
interview. She referred to the jumpsuit 
style uniform worn by flight nurses 
during medical air evacuations. "Sure, 
we like them. They're comfortable, 
even though not the latest in style. One 
pattern does for male and female nurses 
— the zip slides up and down." 

"What's the hazard then?" 

"Well, toilet accommodation on an 
aircraft is somewhat condensed — you 
walk in, tuck arms to sides like a hen's 
wings, slide the zip and suit down, and 
hope!" 

"Hope?" 

"Yes, hope you come out with sleeves 
that haven't wandered down the pan!" 



Science has priority over people 

On December 8, the prime minister of 
Canada was asked in the House of 
Commons if he would consider desig- 
nating a minister of the cabinet to deal 
with the implementation of the recom- 
mendations of the report of the Royal 
Commission on the Status of Women. 
He replied that if the House passed 
the reorganization bill, which gives 
the government greater flexibility in 
appointing ministers, "perhaps [italics 
ours] I will be able to extend that flex- 
ibility . . . . " 

Ten days later, after the first volume 
of the report of the senate committee 
on science had been tabled, the prime 
minister was asked if he would appoint 




22 THE CANADIAN NURSE 



a minister to be responsible for science. 
His reply was in the affirmative. No 
hedging here. 

Our conclusion can only be that the 
P.M. does not take the report of the 
status of women seriously. He puts 
science before people. 

Well, as Leone Kirkwood wrote in 
The Globe and Mail, "Commissioners 
[ of the Royal Commission on the Status 
of Women] can always take hope that 
if the present prime minister does not 
take action, they can look to a future 
one. She may be more sympathetic." 

Those days are gone forever 

Nurses have toppled off their ped- 
estals, is the opinion of a doctor quoted 
by Mary Powell, S.R.N. . M.C.S.F., 
in the British Medical Journal in May 
1970. 

Picking up the pieces. Miss Powell 
said the doctor and administrator in 
the past looked on the nurse rather as 
a Victorian husband looked on his wife. 

You know what that means — the 
little woman always at hand to minister 
to the needs of her lord and master. 
Having left the Age of Victoria for the 
Age of Aquarius, wives, nurses, in 
fact all women, want to be treated as 
equal partners in life's endeavors. 

If the laws of gravity are still in ef- 
fect, the fall from a pedestal is a down- 
ward motion. Although there is conflict 
generated on the health team by nurses' 
struggle for a new status, it surely has 
an upward movement. 

Wash (?) those cuffs! 

You can't trust anything these days. 
A study done in Australia and ab- 
stracted in the November 1970 issue 
of Modern Medicine, shows that clean 
sphygmomanometer cuffs usually be- 
come heavily contaminated with path- 
ogenic microorganisms soon after they 
are brought into a hospital ward and 
are then a possible source of cross in- 
fection. 

The researchers who conducted the 
study report that staphylococcus aureus 
was found on 44 of 48 linen cuffs from 
sphygmomanometers in common use 
in the wards of a hospital. Frequently 
the staphyloccocci were of the same 
phage type as those isolated from pa- 
tients. 

The researchers' advice? Sterilize, 

or at least wash, cuffs that have been 

used on patients with overt skin sepsis. 

FEBRUARY 1971 



for use 
-on the ward 
-in the OR 



-in training 



NEOSPORir 

IRRIGATING 

SOLUTION 

Available: Sienle 1cc. Ampoules. 
Boxes of 10 and 100 

INSTRUCTIONS FOR USE 

This preparaiion is spacifically designed lor use with 5 cc. 
"ihiflo-way" caiherers o( with other catheter systems permit- 
ting continuous irrigation ol the urinary bladder. 

1 PREPARE SOLUTION 

Using sterile precautions, one (1 ) cc. of Neosporin Irriga- 



INSERT INDWELUNG CATHETER 
Catheieri/e Ihe psiient using full sterile precautions. The 
use of an antibacterial lubricant such as Lubasporm* Utethral 
Antibacterial Lubticani is recommended during insertion of 
the catheter 

INFLATE RETENTION BALLOON 

Fill a Luer type syringe with 1 cc. of sterile water or saline 
(5 cc. tor balloon, the remainder to compensate lor the 
volume required by the inflation channel) Insert sytinge 
tip into valve of balloon lumen, inject solution and remove 
^ syringe, 

CONNECT COLLECTION CONTAINER 

■he outflow (drainage) lumen should be aseptically con- 



FTACH RINSE SOLUTION 

e 5 cc. "three-way" catheter should 
V be connected to the bottle of diluted Neosporin 
■rigaiion Solution using sterile technique. 

VAOJUST FLOW-RATE 

' For most patients inflow rale o( the diluted Neosporin 
Irrigating Solution should be adjusted 10 a slow drip to 
deliver about 1.000 cc, every iweniyfoui hours [about 
40 cc. per hour) It the patient's urine output exceeds 2 
liters per day it is recommended that Ihe inflow rate be 
adjusted to deliver 2.000 cc of Ihe solution in a twenty- 
four hour period. This requires the addition of an ampoule 
of Neosporin Irngating Solution to each of two 1,000 CC. 
bottles ot sterile saline solution. 

' KEEP IRRIGATION CONTINUOUS 

It IS important that irrigation of'the bladder be continuous 
The rinse bottle should never be allowed to run dry, or the 
inflow drip interrupied lor more than a few minutes The 
outflow tube should always be inserted into a sterile 



• Convenient product idenlifying labels for use on bottles 
of diluted Neosporin Irrigating Solution are available in e 



, . . ,.,.„ .„„^,., ,„, ^„ „n bottles 

of diluted Neosporin Irrigating Solution are available in eai 
ampoule pecking or from your 'B. W. & Co.' Representativ 




ft 



Burroughs Wellcome & Co. (Canada) Ltd. 



„»«..(7^ 



Neosporirf Irrigating Solution 



INSTRUCTIONS FOR USE 



Designed especially for the nursing pro- 
fession, this Instruction Sheet shows 
clearly and precisely, step by step, the 
proper preparation of a catheter system 
for continuous irrigation of the urinary 
bladder. The Sheet is punched 3 holes to 
fit any standard binder or can be affixed 
on notice boards, or in stations. 

For your copy (copies) just fill in the cou- 
pon (please print) noting your function or 
department Within the hospital. 



Dept. S.P.E. 

Burroughs Wellcome & Co. (Canada) Ltd. 

P.O. Box 500, Lachine, P.O. 

Gentlemen : 

Please send me I 1 copy (copies) of the N.I.S. Instructions for Use. My department or function 

within the hospital is 



NAME. 



ADDRESS. 



CITYORTOW/N_ 



.PROV. . 



*TradP Mark 

FEBRUARY 1971 




Burroughs Wellcome & Co. (Canada) Ltd. 



THE CANADIAN NURSE 23 



iAD 




flBBI^^^^ 



These features are what makes 



dermicel 

Surgical Tape 

the tape of things to come 

— for its hypo-reactivity — making it especially well tolerated by patients with a history 
of tape sensitivity — and of course '>'y>'~^^_^i|i/" not counting Dermicel's special 
ability to peel off the skin — especially hair-bearing surfaces — pain- 




lessly and with an absolute minimum of skin reaction — and if you V-vvsv; 
disre-x^^-T^ gard Dermicel's single ingredient adhesive mass, something of an 
'innovation in the evolution of surgical tape — and finally of course, pro- 
vided you overlook the ultimate difference about Dermicel — the fact that it looks 
different and feels different and is better to work with than traditional surgical tape 




©j&j 



dermicel 

Surgical Tape 

another improvement from 

n n LIMITED 

'Trademark of Johnson & Johnson or Affiliated Companies. 



A look at the Francis Report * 

on the Status of Women in Canada 



No Royal Commission report satisfies 
everyone, and the Francis Report is no 
exception. Some say the commissioners 
did not go far enough in certain areas; 
others say they went too far. Some say 
the report is already outdated, that 
women's liberation movements have 
outstripped it; others say it is ahead 
of its time, that society is unprepared 
to implement its recommendations. 

Despite these differences of opinion, 
few will disagree that the report is a 
well-documented, carefully compiled 
account of the discrimination against 
women that still prevails in Canada. 
The report is a first step, an important 
step, which can lead to radical changes 
if both sexes are prepared to study it 
objectively, react to it, and put pressure 
on governments at all levels to act. 

As the news media have given con- 
siderable publicity to most of the re- 
port's recommendations, we shall con- 
fine ourselves to a few that are of 
particular concern to nurses and nurs- 
ing in Canada. 

Women in the Canadian Economy 

•The commissioners found many in- 
stances where women received less pay 
than men for the same work, even 
though most employees in Canada are 
covered by legislation prohibiting 

* Every commission — Royal or other- 
wise — invariably takes on the name of 
its chairman (e.g.. the Hall Report on 
Health, the LeDain Commission on the 
non-medical use of drugs, the Davey 
Report on the Mass Media, etc.) We shall 
refer to the Report of the Royal Com- 
mission on the Status of Women in Cana- 
da (chaired by Anne Francis) as the Fran- 
cis Report. 



FEBRUARY 1971 



different rates of pay on the basis of 
sex. Several of the report's recommen- 
dations relate to this injustice. 

It is apparent, the Report states, 
that equal pay for equal work will not 
be a fact until all employers and unions 
accept the principle, and until there is 
effective legislation to enforce the 
principle. 

The Report cites the case of female 
nursing assistants and male nursing 
orderlies as the most widely known 
example of controversy over whether 
or not two occupations are sufficiently 
similar to warrant equal pay under the 
law. Pointing out that nursing assistants 
must be provincially licensed after 
completing a 10-month training course 
and that most nursing orderlies have 
no such qualification requirements 
to meet and are usually trained on the 
job, the commissioners said they were 
told of situations where nursing or- 
derlies got higher pay than nursing 
assistants. 

While examining the country's lar- 
gest employer of women — the fed- 
eral government — the commissioners 
found similar discrimination: "The 
predominantly female occupation 
Nursing Assistant and the predom- 
inantly male occupation Nursing 
Orderly have similar duties and respon- 
sibilities. The starting salaries for the 
two classes in the Public Service are 
the same. Yet Nursing Assistants are 
required to have completed a course 
of training, usually 10 months long, 
and to be provincially licensed or 
certified. Nursing Orderlies, on the 
other hand, are trained on the job. 
More than this. Orderlies are auto- 
matically promoted to Specialist Or- 
derlies, with higher pay, after their 
THE CANADIAN NURSE 25 



training and a period of satisfactory 
service; Nursing Assistants are not." 

The Report recommends: that the 
differential treatment of Nursing Assis- 
tants and Nursing Orderlies in the 
federal Public Service be eliminated. 

•The Report states that another reason 
for women's lower earnings is that 
occupations and professions predom- 
inantly female tend to be lower paid 
than those predominantly male. It 
quotes the brief from the Canadian 
Nurses' Association, which says that 
the cause of the shortage of available 
nurses is not so much an inadequate 
number of trained nurses as the fact 
that nurses are entering other occupa- 
tions with better pay and working 
conditions. 

Why have women remained in these 
lower-paid occupations and professions? 
the Report asks. Because women sim- 
ply do not have as many occupation..! 
alternatives as men. To change this, 
people must stop thinking of partic- 
ular jobs as the domain of one sex or 
the other, the Report states, and em- 
ployers must show they are willing 
to change by hiring women in male 
occupations and men in female occupa 
tions. 

The Commissioners believe this 
change in attitude will take time. They 
urge the federal government to show 
leadership now by counteracting some 
of the ill-effects of occupational seg- 
regation on women's earnings. In other 
words, instead of following rates paid 
in the community — its usual policy 
— the federal government should lead 
the way and "accelerate this adjustment 
in . . . traditionally female professions 
now short of workers." 

The Report recommends: that the 
pay rates for nurses, dietitians, home 
economists, librarians and social work- 
ers employed by the federal government 
be set by comparing these professions 
with other professions in terms of the 
value of the work and the skill and 
training involved. 

•The commissioners said the federal 
government has shown little leader- 
26 THE CANADIAN NURSE 



ship in giving women a chance to show 
they have capacities comparable to 
men. A review made in 1969 by the 
Commission revealed that on the boards 
of directors of 97 federal agencies. 
Crown Corporations, and Task Forces 
there were 639 men and only 42 wo- 
men. Women comprised only 6.3 per- 
cent of those appointed and 74 of these 
organizations had no women members. 
"We are convinced that qualified 
women are available," the Report 
states, "and we believe that these bodies 
may profit from management that 
reflects the views and experience of 
women as well as those of men. There- 
fore, we recommend that the federal 
government increase significantly the 
number of women on federal Boards, 
Commissions, Corporations, Councils, 
Advisory Committees and Task Forces. 
Further, we recommend that provin- 
cial, territorial, and municipal govern- 
ments increase significantly the number 
of women on their Boards, Commis- 
sions, Corporations, Councils, Advisory 
Committees and Task Forces." 



Poverty 

•To be old means, far too often, to 
be poor, the Report states. "... el- 
derly women, single or widowed, are 
left behind in our society. Thousands 
are living lives of loneliness and depri- 
vation. Although not starving, they 
are undernourished at a time when 
they need a good diet to maintain their 
health." 

The Commission's conclusion is 
that Canada's old age security system 
is based on an excellent formula of 
payments, but lacks generosity. If so- 
cial rights are to be at all meaningful, 
the standard of living of the aged should 
not be allowed to decline when the 
general standard of living in the country 
is rising. 

The Report recommends: that (a) 
the Guaranteed Income Supplement to 
the Old Age Security benefits be in- 
creased so that the annual income of 
the recipients is maintained above the 
poverty level, and (b) the Supplement 
be adjusted to the cost of living index. 



Participation of Women in Public Life 

•The Report states the obvious — 
that the voice of government is still a 
man's voice, and the formulation of 
policies affecting the lives of all Cana- 
dians is still the prerogative of men. 
It adds that the absurdity of this situa- 
tion was illustrated when debate in 
the House of Commons on a change 
in abortion law was conducted by 263 
men and I woman. 

"Nowhere else in Canadian life is 
the persistent distinction between male 
and female roles of more consequence. 
No country can make a claim to having 
equal status for its women so long as 
its government lies entirely in the hands 
of men. The obstacles to genuine par- 
ticipation, when they lie in prejudice, 
in unequal family responsibility, or 
in financing a campaign, must be ap- 
proached with a genuine determination 
to change the present imbalance. 

"In pursuit of this aim women must 
show a greater determination to use 
their legal right to participate as citi- 
zens. They must reconsider the reasons 
that have kept them from ehtering 1 

nnlitire " c^ ^ 



politics . 



* 



FEBRUARY 19711 



OPINION 



Catchbasins^ 
debentures^ subsidies 
and garbage cans 

An alderman, who is also a registered nurse, urges nurses to play an 
active role in politics. 




Mary M. Conroy, B.Sc.N. 

It is only since 1926 that women in 
Canada have been legally recognized 
as persons. And whether or not we 
agree with the Women's Liberation 
Movement, most of us do believe that 
its ultimate aim, a wider acceptance 
of women as individuals, is desirable. 
Women have a definite role to play in 
shaping our society, and this includes 
the important sphere of government. 
To most of us, the form of government 
that we can most easily influence is 
municipal government. 

Municipal government touches our 
lives daily, and in many practical ways. 
It touches areas that are the special con- 
cern of women: sewage treatment, wa- 
ter supply, garbage pick-up, safe streets 
and roads, and the education of our 
young. Municipalities now assume some 
of the responsibility to provide adequate 
housing for people who lack the means 
to provide for themselves, especially 
the aged. 

I submit that women have abrogated 
their responsibilities as citizens for 
these and other matters. In Ontario 



Mrs. Conroy, mother of three, has com- 
bined family life, a nursing career as 
lecturer in microbiology and relief super- 
visor at Sudbury Memorial Hospital, and 
political activity. Currently she is enrolled 
in the third year of a law clerk course at 
Cambrian College of Applied Arts and 
Science, Sudbury Campus. 



FEBRUARY 1971 



last year there were 7 controllers, 39 
aldermen and councillors who were 
women, and only 14 of the 39 aldermen 
were in cities with a population of more 
than 10,000. There is only one woman 
member in the federal house, and there 
are only two women members in the 
Ontario Legislature. 

Nurses and government 

There is much to be done by women 
in local government, and nurses should 
involve themselves. As a nurse and a 
citizen, are you not interested in the 
provision of a safe, healthful water 
supply, a sanitary sewage system, the 
provision of an appropriate number of 
parks and open spaces to allow people 
to thrive in your community? Are you 
not interested in adequate housing, the 
well-being of the poor, and an envi- 
ronment free of pollution? 

In my experience, nurses tend largely 
to be content to serve their fellowman 
through their profession, sometimes 
inadvertently isolating themselves from 
the other needs of their community. 
But the broad general education they 
receive and the specialized training and 
education in sociology, psychology, 
child development, public health, ob- 
stetric and geriatric nursing represent 
invaluable knowledge and skills that 
would stand any person in good stead 
when dealing with the wide range of 
problems confronting communities 
today. 

THE CANADH^N NURSE 27 



Many nurses with additional prepara- 
tion in administration can understand 
and help to improve the conduct of 
local government. Participation in 
nursing organizations helps them to 
understand the rudiments of parlia- 
mentary procedure and organizational 
details that are part of a councillor's 
job. Nurses are better prepared to par- 
ticipate effectively in municipal gov- 
ernment than are most local politicians. 

Personal involvement in politics 

For the past three years I have served 
as an alderman in the city of Sudbury 
as the only woman alderman on our 
council, the third woman to be involved 
in local politics at the council level since 
the founding of our city 70 years ago. 
I can admit that there are many frustra- 
tions and disappointments, but the 
rewards outweigh these. 

Politics is not a dirty word. Many 
people shy away from involvement, 
thinking there is something shady about 
politics. There is not, nor need there 
be. Politics provides the machinery to 
achieve good government. But politics 
is also service-oriented — there can be 
as much satisfaction in helping citizens 
with their problems and improving the 
community as there is in helping an 
individual regain his health. 

If politics is corrupt, dirty and nas- 
ty, in your community, it may be that 
it will always be that way unless women 
become actively involved. Nurses have 
a great deal to give. 

Primarily, a council member is elect- 
ed to represent the interests of a group 
of people in a geographic area of a city. 
She does this in council, on committees 
and boards and commissions. She par- 
ticipates in making decisions that affect 
the city as a whole. She can be an ef- 
fective means of communication be- 
tween the people who elected her and 
the bureaucracy that exists in gov- 
ernment. 

Women in politics 

Julia Thompson, a lobbyist in Wash- 
ington for the American Nurses' As- 
sociation, once said that women in 
politics need firmness, friendliness, 
femininity, and fortitude!* An effective 
politician, of whatever sex, must be 
able to withstand pressures that she 
considers detrimental to the common 
good. She has to be friendly, approach- 

* Virginia A. Lindabury, A look at ANA's 
legislative program. Canad. Nurse 65:7: 
22-4. July 1969. 
28 THE CANADIAN NURSE 



able, and able to talk to people. She 
has to remain feminine. A woman in 
politics must fight a tendency to become 
"one of the boys" or "hard." She ought 
not to talk like a man, nor act or look 
like one. However, if she wants to have 
the same opportunities as a man, she 
must be prepared to accord at least 
the same time and effort to a task as 
he does. 

A councillor, to be effective, keeps 
uppermost in her mind the people she 
represents, is observant, attentive, and 
listens intelligently. She has an open 
mind, and must think things through 
by considering what the end result will 
be, what complications will be encoun- 
tered, how people willbe affected. Recog- 
nizing that the mute, passive thinker is 
useless, she enters fully into discussions, 
and participates in debates. She attacks 
a problem, not people, and disagrees 
if necessary, but does so agreeably. 
A councillor knows enough to temper 
candor with tact, to avoid agreeing for 
the sake of agreeing, to speak freely 
without monopolizing a meeting. She 
guards against making snap decisions 
before considering all the implications, 
and has sound reasons for her own 
objections. She is loyal, honest, and 
pleasant. 

With experience, other skills are 
developed: how to explain an issue to 
a ratepayer so he can understand it, 
seeing another's pxiint of view, the 
ability to listen and to learn. A coun- 
cillor gradually becomes strongly deter- 
mined to stand up for what she thinks 
is best for the majority of the electorate, 
even if she must stand alone, but she 
retains the courage to admit being 
wrong. 

Above all, a councillor must have 
a sense of humor to enable her to laugh 
at herself, and a skin thick enough to 
prevent criticism from disturbing her 
unduly. However, if the criticism is 
justified, she will learn from it. 

Municipal politics, like other fields, 
has its own special terms. Debentures, 
assessment, mill rate, catchbasins, per 
capita grants, and so on, are foreign 
to most women at first. A few evenings 
studying a text on municipal govern- 
ment, a short course on municipal 
government, such as those offered in 
most community colleges and night 
schools, and regular attendance at coun- 
cil meetings (which, of course, are open 
to the public) will familiarize a coun- 
cillor with the local issues. Regular 
reading of the local news of the daily 
newspaper will also help her become 
familiar with the particular issues of 



her community. Most fledgling male 
politicians are equally bewildered and 
few take the trouble to prepare them- 
selves! 

Involvement in local government 

If being an active member of your 
local government, either on the munic- 
ipal council or school board, just isn't 
for you, you can still influence the 
quality of your civic government in 
many other ways. 

Cast your vote on election day; 51 
percent of electors are women and 
this can most emphatically influence 
who gets elected to office. If you know 
someone who is running for office, make 
yourself known to her; offer to tele- 
phone a list of people for her. During 
my last campaign, those who did my 
telephoning made 10 calls each, and 
they said it took less than an hour. 
Offer to babysit while mothers go to 
the polls, have coffee parties so your 
friends and neighbors can meet the 
candidate. Stuff envelopes, address 
campaign materials, knock on doors! 
Know the issues involved: take a few 
minutes a day to read the local news- 
paper. 

If you don't want to run for office, 
investigate the numerous appointed 
boards and commissions, such as the 
library board, planning board, parks 
and recreation commission, the health 
unit board. In our community a nurse 
helped me considerably with my cam- 
paign. Later, I was able to put her name 
forward to serve on the planning board 
where she is making an effective con- 
tribution and enjoying it. 

Keep your councillors informed ofj 
problems in your area and how you' 
feel about issues. Unless the electorate 
provides councillors with some "feed- 
back" it is impossible to represent them 
adequately. 

Hats off for the political ring 

All of us wear many hats in our 
lives, we play many roles. Less and less 
often women go to "pink teas" wearing 
the symbolic flowery hat — a shield 
behind which many hide from respon- 
sibilities in the world. Don't let your 
own snowy-white nurse's cap isolate 
you from your responsibilities as a 
citizen. Why don't you take off your cap 
and throw it into the political ring? 
Being a member of your local govern- 
ment is an exciting, worth-while activ- 
ity. Try it; you won't regret it. W 



FEBRUARY 1971 



i 



Preadmission orientation 
for children and parents 

How one hospital helps its pediatric patients adjust to the realities 
of hospitalization. 



Margaret Joan Brown 




A young child's first experience as a 
hospital patient can be frightening. 
He may never have visited a hospital, 
yet have a strongly preconceived idea 
of one, stimulated by his active imagi- 
nation. He may have overheard adult 
conversations he does not entirely 
understand, or have been subjected 
to exaggerated accounts by his play- 
mates who have been patients in hospi- 
tal. The capacity to reason and to dif- 
ferentiate between fact and fancy may 
not yet be developed, allowing his 
fantasies and fears to lead to an unreal- 
istic interpretation of what a stay in 
hospital can be. 

Established programs 

In many centers in the United States 
there are established programs design- 
ed to make admission to hospital a 
positive emotional and physiological 
experience for children. 

In Oakland, California, nursery 
school children join a program called 
"Through the Looking Glass" at 
Children's Hospital of the East Bay for 
preadmission orientation. These chil- 
dren are not necessarily about to be 
admitted to hospital.' 

Miss Brown, a graduate of the Royal 
Alexandra Hospital. Edmonton, Alberta, 
is Head Nurse of pediatrics at Sturgeon 
General Hospital, St. Albert. Alberta. 
Previously she was a general duty nurse 
on pediatrics at the Royal Alexandra. 



FEBRUARY 1971 



In Detroit, Michigan, the Children's 
Unit at the Lafayette Psychiatric Clinic 
has instituted a preadmission conference 
where a child and his parents meet 
with three or more members of the 
medical staff, one or more nurses from 
the children's unit, and a social worker 
to develop plans for initial care and 
treatment. This is followed by a tour 
of the children's ward. ^ 

In St. Paul, Minnesota, a student 
nurse from the pediatric unit of St. 
Joseph's Hospital visits the home of a 
preschool child one or two days prior 
to his admission to hospital. Her pur- 
pose is to allay parental anxiety and to 
tell the child, if old enough, what to ex- 
pect during his stay in hospital.^ 

Supporting studies 

Vernon has reviewed studies showing 
that unfamiliarity or lack of adequate 
information tended to produce signs of 
stress in normal children? Among 
these studies, only one indicated that 
preparation for hospitalization result- 
ed in psychological benefit. In other 
studies, children with such preparation 
showed no significant improvement 
in immediate responses. However, in 
several studies where young patients 
had not been prepared for hospitaliza- 
tion, the incidence of psychological 
upset after discharge from hospital 
was greater and lasted longer, s 

The results of these studies point to 

a decrease in psychological upset if 

THE CANADIAN NURSE 29 




children are prepared for hospital. 
Another finding is that time spent 
by personnel in conducting an orienta- 
tion program is offset by a reduction 
in time needed to care for these chil- 
dren during their stay in hospital.^ 

Orientation program at Edmonton 

The preadmission orientation pro- 
gram for children at the Royal Alex- 
andra Hospital, Edmonton, Alberta, 
is an attempt to reduce anxiety in child- 
ren about to be admitted to hospital 
for elective surgery. 

The Tuesday before a child is to be 
admitted, the admitting officer notifies 
the parents and invites them to attend 
the preadmission orientation program 
to be held on Friday afternoon. To 
be most effective an orientation pro- 
gram should allow enough time for a 
child to think about hospitalization, 
30 THE CANADIAN NURSE 



but not enough time to build up anxie- 
ties about it. 7 

At 1.30 P.M. on Friday, the young 
prospective patients and their parents 
are greeted by the pediatric supervisor. 
Each child is given a "magic number," 
that of the unit to which he will be ad- 
mitted. 

An information session follows. The 
business officer says a few words about 
the discharge and billing of patients. 
Then, the director of admitting dis- 
cusses admitting procedures. While 
explaining the need for identification, 
an Identi-Band is placed on the wrist 
of a young volunteer. A fashion show 
then captures the interest of the chil- 
dren as they see hospital personnel mod- 
eling their uniforms, and finally a nurse 
and a doctor appearing in operating 
room dress complete with mask and OR 
boots. The commentary is light and 



cheerful, in language easily understood 
by the young visitors. 

Toward the end of the program rep- 
resentatives from the units, bearing 
one of the "magic numbers" assigned 
to the children, conduct the visitors 
on a tour, beginning with the coffee 
shop, gift shop, and barber shop, then 
the admitting area and the laboratory. 
Later, in the operating room, the equip- 
ment is demonstrated by a doctor and 
a nurse who invite the children to lie 
on the operating table, to see how a res- 
traint feels, and to have a rubber tour- 
niquet applied. 

The tour ends in the nursing unit 
itself, with its interviewing and examin- 
ing rooms where the child will later be 
admitted. A demonstration of beds, 
bedside tables, individual equipment, 
meal trays, and hospital gowns follows. 
Then, in the dressing room, the chil- 
FEBRUARY 1971 



Barbara Wood, R.N., and Blanche 
Thompson, C.N. A., serve children ice 
cream and juice at the orientation party 
held at the Royal Alexandra Hospital, 
Edmonton. 



dren are told about having temperatures 
taken, being given suppositories, and 
the preoperative injection. 

Children's party 

Then follows a party in the play- 
room for the children themselves. It 
has been said that a child should not be 
told that his stay in hospital will be fun, 
or like a party. s At the Royal Alexandra 
Hospital the party is considered to 
produce a feeling of separation from 
the hospital environment and to give 
the child a chance to acquire new friends 
whom he often remembers when he is 
admitted to hospital the following week. 

The party occupies the child while 
his parents are in the classroom where 
a child psychiatrist and the pediatric 
supervisor discuss problems of hospital- 
ization. The supervisor explains per- 
missive visiting, the facilities available 
to parents, hospital routines and poli- 
cies. Parents are encouraged to bring 
the child's "security" item to hospital. 

The child psychiatrist stresses the 
importance of telling the child the 
truth, of the father visiting his child, 
and of parents maintaining self-control 
in front of their child. 

He tells how to explain surgery to 
children of different ages, including 
the need to repeat information to allow 
a child to remember. The child psy- 
chiatrist mentions possible postoper- 
ative complications and discusses what 
reactions a child may have to his par- 
ents after surgery. The parents are 

FEBRUARY 1971 



encouraged to express their anxieties 
and to ask questions about their child's 
pending operation. 

Results of preparation 

Although there have been no official 
studies to measure the effectiveness of 
the program at the Royal Alexandra 
Hospital, the nursing staff have noted 
a difference in the attitudes of chil- 
dren who have participated in their 
orientation program. Anesthesiologists 
at the Royal Alexandra Hospital have 
stated that they too can identify those 
children who have been prepared for 
hospitalization through the orienta- 
tion program. This program seems to 
have the greatest effect on children 
between four and six years of age. 

Orientation programs at several other 
hospitals have shown positive effects. 
At Children's Hospital of the East 
Bay, Oakland (where "Through a Look- 
ing Glass" is conducted) the children 
participating in their program seem to 
make a better adjustment than those for 
whom hospitalization is a totally new 
experience. 9 However, the East Bay 
program may be of limited value be- 
cause of the indefinite lapse of time 
between preparation and hospitaliza- 
tion. 

Through the program at Lafayette 
Psychiatric Clinic, the staff is able to 
observe the family as a unit, noting the 
parents' attitudes and responses to 
their child. The family conference 
also permits communication among 
all disciplines while developing a 
treatment plan.'° 

Because the nurse at St. Joseph's 
Hospital has seen the child and his 
parents in the family setting, she can 
better evaluate the emotional support 
that both child and parents will need.^i 

The results of these programs in- 
dicate the desirability of some form of 
pre-hospitalization orientation. Factors 
to be considered in determining content 
and presentation of the orientation 
programs are: 1 . the child's age; 2. time 
of preparation; 3. information pertinent 
for parents; and 4. information neces- 
sary for the child. 

More research is required to deter- 



mine the effectiveness of existing 
programs and to investigate means of 
improving them. A need exists for ed- 
ucative measures that can reduce the 
psychological stress of hospitalization 
for the child. 

References 

1. Through a looking Glass. Hospitals. 

34;47 Jan. 16, 1960. 

2. Chace, Kathryn S. The pre-admission 
conference — a tool for planning nurs- 
ing care. J. Psychiat. Niirs. 3:490. 
Nov.-Dec, 1965. 

3. Geis, Dorothy P. and Rochon. Sister 
Dolore. Home visits help prepare pre- 
schoolers for hospital experience. 
Hospitals. 40:87 Feb. 16, 1966. 

4. Vernon, D.T.A., Foley, J.M.. Sipo- 
wicz, R.R., and Schulman, J.L. The 
Psychological Response of Children 
to Hospitalization and Illness. Spring- 
field. Illinois, Charles C. Thomas, 
1965. p.lO. 

5. Ibid.. p.2\. 

6. Ibid., p. 14. 

1 . Blatherwick. Carol E. The pediatric 
orientation-to-hospital program. Al- 
berta Medical Bulletin, Feb. 1969, 
p. 12 

8. Geist, H. A Child Goes to Hospital. 
Springfield, Illinois. Charles C. Thom- 
as, 1965, p.22. 

9. Through a looking glass. Hospitals, 
34:47, Jan. 16, 1960. 

10. Chace, Kathryn S. The pre-admission 
conference — a tool for planning 
nursing care. J. Psychiat. Nurs. 
3:495, Nov.-Dec, 1965. 

1 1. Geis, Dorothy P. and Rochon, Sister 
Dolore. Home visits help prepare pre- 
schoolers for hospital experience. 
Hospitals, 40:87, Feb. 16, 1966. '^ 



THE CANADIAN NURSE 



31 



Carotid artery stenosis 
with transient ischemic attacks 



Many patients with carotid artery stenosis can now be helped to live normal 
lives. The author describes the surgical treatment and nursing care of one 
patient who benefited from this operation. 



Gelske VanderZee 



While reading the paper one evening, 
Mr. A., a 49-year-old social worker, 
suddenly found he could see only the 
right half of the sports page. This symp- 
tom was transitory, lasting a few sec- 
onds. The following day the same symp- 
tom recurred. In addition, he had a 
"funny feeling" in his left arm, as though 
the arm did not belong to him. He 
phoned Dr. J., his family physician, 
who came and examined him. 

A neurosurgeon was consulted. He 
agreed with Dr. J. that the patient 
should be admitted for investigation, 
and arrangements were made. The 
provisional diagnosis was carotid ar- 
tery stenosis with transient ischemic 
attacks. 

On admission to the neurosurgical 
unit, Mr. A's blood pressure was 
120/70. He was able to move his arms 
and legs, had no visual disturbance. 



Miss VanderZee, a graduate of the Dla- 
conessehuis Hospital, Leeuwarden, in 
the Netherlands, is Head Nurse of a 
neurosurgical unit at the Toronto General 
Hospital. This article was adapted from a 
speech the author presented in Toronto 
at the June 1970 meeting of the Canadian 
Association of Neurological and Neuro- 
surgical Nurses. 



32 THE CANADIAN NURSE 



but said he had noticed one of his "fun- 
ny attacks" while waiting admission. 

He was allowed to be up and around 
the unit, given a regular diet, and ad- 
vised to stop smoking, as nicotine con- 
stricts the arteries. 

The neurosurgical resident examined 
Mr. A. and ordered routine blood and 
urine tests, skull and chest x-rays, a 
blood sugar to rule out diabetes melli- 
tus, and an electrocardiogram to de- 
termine his cardiac status. A coagula- 
tion screen was done and the reports 
indicated no bleeding or clotting dis- 
corders. His physical examination was 
normal, except for a bruit heard over 
the right carotid artery. This was a 
swishing noise as the blood passed 
through the narrowed lumen of the 
artery. 

To prevent the formation of small 
thrombi, anticoagulant therapy was 
instituted, the dosage based on a daily 
prothrombin time. (A prothrombin time 
of 20 seconds, with a normal control 
of 1 1 or 12 seconds is desirable.) 

A percutaneous carotid arteriogram, 
performed to visualize the neck and 
cranial vessels, revealed a 75 percent 
stenotic lesion in the right carotid ar- 
tery. The carotid and vertebral arteries 
are the main source of blood supply to 
the brain. In performing an endarter- 
FEBRUARY 1971 





Angiography done preoperatively shows stenosis of the 
right carotid artery. 



Angiography done six 
a patent artery. 



postoperatively shows 



ectomy, the artery is temporarily 
occluded, so it is essential for the other 
vessels to provide an adequate blood 
supply to the brain. 

After the carotid arteriogram, Mr. 
A. was closely observed for neck swel- 
ling, bleeding at the site of the puncture 
wound, speech difficulty, dysphagia, 
weakness of arms and legs, and change 
in level of consciousness. As symptoms 
may be aggravated following an arterio- 
gram, any change in the patient is 
reported immediately. 

The decreased blood flow had caused 
the symptoms Mr. A. experienced, 
which he feared was the beginning of 
a cerebrovascular accident. His first 
symptom had been impaired vision; 
if untreated, he probably would have 
developed first partial, then complete, 
hemiparesis, and would have been 
unable to carry on his work. 

Carotid stenosis with ischemic 
attacks usually occurs in the 40 to 50 
age group, and is more common in men 
than in women. A stenosis can be the 
result of calcium deposit in the lumen 
of the artery, which usually has a small 
ulcer with resulting thrombus. It is at 
FEBRUARY 1971 



the bifurcation, and sometimes the 
thrombus extends upward into the 
intracranial portion of the artery. As 
the artery narrows, the patient experi- 
ences symptoms similar to Mr. A.'s. 

Treatment 

Research over the last decade has 
made it possible to assist patients who 
have a diagnosis of transient ischemic 
attacks. Successfully treated, they can 
return to their employment and contrib- 
ute to the community, rather than be- 
come invalids at an early age. 

The neurosurgeon decided to treat 
Mr. A. surgically, and discussed the 
procedure with the patient and his 
wife. Family involvement is essential, 
as members of the family are the ones 
who can best give the patient moral 
support preoperatively, postoperatively, 
and when he returns home. 

The physiotherapist assisted both 
pre- and postoperatively by teaching 
Mr. A. to breathe properly and by 
giving him breathing exercises to do. 

In preparation for surgery, Mr. A. 
was typed and cross-matched for six 
units of blood. Early on the morning 



of surgery, a prothrombin time was 
done. If the prothrombin time had been 
above 20, the risk of bleeding would 
be too great and surgery would have 
been delayed until it was 20. 

The patient had been told that after 
his surgery he would spend a few days 
in the intensive care unit, where he 
would be given more constant attention 
and care. 

The anesthetist was no stranger to 
Mr. A., and assisted the surgeon in 
planning the patient's management. 
He visited Mr. A. and examined him 
to rule out any condition that would 
contraindicate the giving of a general 
anesthetic and the possible use of 
hypothermia and hypertension. 

Surgical procedure 

The arteries can be clamped off for 
a longer period if surgery is done with 
the patient under hypothermia, as less 
oxygen is required at a lower tempera- 
ture. Thirty degrees centigrade is an 
ideal level for surgery performed under 
hypothermia. The patient's vital signs 
and temperature are monitored and 
closely followed, and induced hyper- 
THE CANADIAN NURSE 33 



Postoperatively, the patient's neck 
circumference is measured and a line 
drawn on the dressing over the center 
of the incision. This acts as a guideline 
for future comparison. An increase 
in the circumference could indicate 
bleeding. 




The patient's dressing is usually remov- 
ed five days postoperatively. If the 
wound has healed and no obvious 
hematoma is present, the sutures are 
removed on the tenth day. 




34 THE CANADIAN NURSE 



FEBRUARY 1971 



tension is used as an added measure 
to ensure adequate blood supply. 

Guided by the location of the steno- 
sed area as shown by the carotid arte- 
riogram, the surgeon exposes the artery. 
The artery is then clamped off with 
rubber-tipped "bull-dog" clamps below 
and above the stenosed area. An inci- 
sion is made over the stenosed area 
visible through the artery wall. The 
calcium plaque is shelled out with a 
small, blunt, spoon-shaped instru- 
ment — the aim being to establish a 
good retrograde flow. 

In Mr. A.'s case, good blood flow 
was established on removal of the 
plaque. The artery was closed with a 
firm 5.0 running suture. 

In this type of surgery, care is taken 
to have the inner side of the artery 
meticulously sutured so a smooth suture 
line results, reducing the possibility of 
thrombi formation. In patients where 
more than one artery is involved, or 
where an artery is completely occluded, 
a bypass procedure is used. 

Postoperative care 

When Mr. A. was returned to the 
intensive care area on the unit, his 
bedside was ready with all needed 
equipment close at hand. Level of 
consciousness, vital signs, and move- 
ment of extremities were checked hour- 
ly. In addition, Mr. A's neck circumfer- 
ence was measured with a tape measure. 
A line was drawn on the dressing over 
the center of the incision, acting as a 
guideline for future comparison. An 
increase in the circumference could 
indicate bleeding. 

A clot can be disastrous, as the tra- 
chea is close to the vessels involved; 
pressure from the clot on the trachea 
would result in dyspnea. Anoxia, 
dysphagia, or any evidence of bleeding 
on the dressing is reported immediately. 
To relieve severe respiratory distress, 
an emergency tracheostomy may be 
necessary. 

Mr. A.'s blood pressure and pulse 
were followed closely for several days. 
A drop in blood pressure slows the 
blood flow sufficiently to allow thrombi 
FEBRUARY 1971 



to form. Bradycardia, or slow pulse, is 
the result of carotid sinus stimulation 
and is dangerous, especially in a patient 
with a weak heart that cannot pump 
sufficient blood to the periphery. This 
insufficiency, in turn, slows the blood 
flow and causes thrombi to form. To 
reverse the bradycardia, atropine is 
ordered, usually given subcutaneously. 
In severe cases, an atropine drip may be 
necessary. 

Mr. A. was still drowsy when he 
returned to the unit. Anticoagulant 
therapy was resumed immediately 
postoperatively. Daily prothrombin 
times were done, and the dosage ordered 
accordingly. When fully conscious, he 
was given sips of water to make sure 
he had no difficulty swallowing. 

Traction on the 9th, 10th, and 12th 
cranial nerves during surgery can result 
in temporary palsy of each of these 
nerves. Because of the possibility of 
aspiration with dysphagia, duodenal 
feeding can be instituted until the dan- 
ger of aspiration is past. Mr. A. had no 
difficulty in swallowing and retaining 
fluids; he was given fluids the first day, 
and a soft diet the second day. 

The head of Mr. A's bed was elevat- 
ed. His blood pressure was then 
checked and recorded. If a patient's 
blood pressure level drops, the angle 
of elevation is reduced; if it remains 
constant, the angle of elevation is grad- 
ually increased. As Mr. A. had no 
decrease in his blood pressure level, 
the angle of elevation and the amount 
of activity allowed were gradually 
increased until he was up and about. 
Some patients require Tensor bandages 
on their legs to prevent the blood pres- 
sure from dropping too much. 

The dressing was removed on the 
fifth day, the wound cleaned with 80 
percent alcohol, and a light gauze dres- 
sing applied. If a wound has healed and 
no obvious hematoma is present, the 
sutures are removed on the 10th day. 
The patient is allowed to move his neck 
as freely as he wishes. He can shave, 
except for the area close to the incision, 
which is left unshaven until the sutures 
are removed. 



The physiotherapist visited Mr. A. 
daily to assist with the chest routine to 
prevent pneumonia. 

Preparations for Mr. A's discharge 
were started when his prothrombin 
time leveled off and the daily required 
dosage of anticoagulants had been 
regulated. 

Dr. J., the family doctor, was con- 
tacted and he agreed to follow Mr. 
A's progress and to manage his anti- 
coagulant therapy. Mr. A. will remain 
on anticoagulant therapy for six 
months. The neurosurgeon explained 
to Mr. A. the dangers of being on anti- 
coagulant therapy, such as excessive 
bruising, prolonged bleeding from a 
small cut, and hematuria. He was ad- 
vised to report to his family physician 
immediately if any of the above signs 
or symptoms occurred. 

Mr. A. can return to his position 
as a social worker as soon as he feels 
able to. He is to be guided by common 
sense and to curtail or increase his 
activities accordingly. Earlier, he had 
followed the doctor's advice and stopped 
smoking. 

Mr. A. will be readmitted to the unit 
in six months for reevaluation. A carotid 
arteriogram of the repaired site will 
be performed then: if it shows a good 
patent artery, the anticoagulant therapy 
will be discontinued. 

When first admitted, Mr. A. was 
nervous and apprehensive. His father 
had had a cerebrovascular accident at 
the age of 52, and Mr. A. feared a sim- 
ilar illness. When he was readmitted 
for reevaluation he was cheerful and 
talked of his work. In his own words: 
"You know. Doctor, you did such a 
good repair, I think that artery will 
last me the rest of my life. And I sure 
am glad I am not an old man after all." 



THE CANADIAN NURSE 35 



Sending someon 

HERE ARE SOME TIPS... 



"I enjoyed the conference, but 
what can I tell the group? I don't 
know what they want to hear! " 

This comment is heard -frequently 
when delegates return from sem- 
inars, workshops, and conferences. 
The instructors in the inservice 
education department of the 
Winnipeg General Hospital have 
identified some factors that can 
make reporting easier and more 
interesting. 

Our thoughts are meant to serve 
only as a catalyst for meaningful 
participation at workshops and sem- 
inars and as a stimulus for creative 
reporting. We will leave the actual 
presentation to your imagination. 



Mrs. Alma McKone, Director, Inservice 
Education, Winnipeg General Hospital, 
Winnipeg, Manitoba. 

ILLUSTRATED BY FRAN KUC . 




1. Hold a pre-conference meeting where the delegate talks with those to 
whom she will report. 

Use this time to: 

■ Identify questions people would like answered. 

■ Note areas in which the group would like more information. 

■ Reinforce the idea that the delegate attends with certain responsi- 
bilities. 

■ Discuss the delegate's expectations. 

■ Help the delegate understand that her precise objectives may not be 
met and that unexpected information may be available. 

This meeting will help to prepare the delegate and to stimulate expec- 
tations among those to whom she will report. 



36 THE CANADIAN NURSE 



a oonforence ? 




2. Encourage the delegate to read 
ahead of time the topics to be 
discussed. 

This should stimulate her interest 
and provide a broad background 
against which she can relate the 
material presented. 





4. Help the delegate plan ahead of 
time to capture the spirit and 
meaning of the conference. 

Where appropriate you may sug- 
gest: 

■ Taping of the sessions. 

■ Noting "quotable quotes' 
salient points. 

■ Gathering hand-out material. 

■ Filming impressive ceremonies 
and events. 



and 



3. Encourage the delegate to 
mingle with others attending and to 
make maximum use of these 
informal learning opportunities. 

The delegate may also find she has 
information she can share with 
others. 



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5. Plan to have the delegate report 
on the conference at the earliest 
possible date. 

Her enthusiasm will almost certainly 
wane in direct relationship to 
the time that elapses between the 
events and her presentation. 

With this preparation, the delegate 
should be able to enjoy the 
conference and make her report a 
learning experience for her listeners. 

She will: 

■ Know the questions the group 
want answered. 

■ Be aware of areas in which the 
group needs more information. 

■ Have noted "quotable quotes" 
and salient points. 

■ Have printed material, tape 
recordings, or films from which 
to fashion her report. 

She may also find it helpful to 
outline: the issues discussed; 
the background of each speaker; 
the stands taken by the speakers; 
the reasons for their stand; and 
audience reaction or support. 

THE CANAD^N NURSE 37 



The child with Hurler's syndrome 



Description of the care given to children who have a rare hereditary 
disease for which there is no known cure. 



One of the causes of mental retardation 
in children is a relatively rare disease 
called Hurler syndrome. This disease 
results in progressive mental and phys- 
ical deterioration, usually beginning 
in infancy and culminating in death by 
7 to 10 years of age. 

Hurler's syndrome is a mucopoly- 
saccharide storage disease, one of sev- 
eral inherited disorders of connective 
tissue resulting from a defect in the 
metabolism of acid mucopolysaccha- 
rides. Acid mucopolysaccharides are 
a group of closely related macromole- 
cules formed by a series of carbohydrate 
units linked to a protein core. They are 
normally found, individually or in 
mixtures, as a dominant component of 
the ground substance of the connective 
tissues of the body. 

The accumulation of abnormal 
amounts of one or more acid mucopoly- 
saccharides in the connective tissues 
results in abnormal development, usu- 
ally with gross physical changes, de- 
pending on which organs are more 
severely affected. 

The disease probably is transmitted 
as an autosomal recessive trait, that 
is, both parents must contribute a defec- 
tive gene before the disease is expressed 
phenotypically. The genetic biochemi- 
cal defect that results from this double 
dose of recessive genes is unknown.' 

Signs and symptoms 

Although the newborn infant appears 
normal, the disease becomes evident 
during infancy or early childhood, 
with progressive mental and physical 
deterioration. The first signs are usually 
lumbar gibbus (hump), stiff joints, chest 
deformity, and rhinitis. ^ 

Skeletal development becomes in- 
creasingly grotesque, and the child 
develops a prominent forehead, flat- 
i8 THE CANADIAN NURSE 



Maureen Brenchley 

tened bridge of nose, broad hands, and 
stubby fingers. Stiffening of the finger 
joints causes clawhand. Facial features 
become coarse and ugly, with ocular 
hypertelorism (widely-spaced eyes), 
wide nostrils, large thick lips, open 
mouth, and enlarged tongue. Hyper- 
trophic gums are common with small, 
widely-spaced, peg-like teeth. 

Nasal congestion, noisy mouth 
breathing, and frequent upper respir- 
atory infections occur because of the 
malformation of facial and nasal bones. 
Impaired bone conduction, resulting 
from malformation of the inner ear 
bones, sometimes causes deafness. 

Short neck, deformed chest with 
flaring of the lower ribs, and enlarged 
liver and spleen contribute to the rotund 
appearance of the patient. Hepatos- 
plenomegaly is associated with defective 
supporting issues, and commonly causes 
hernias and a protuberant stomach. 
The child's entire body is usually cov- 
ered with fine fuzz. 

Contractures of hips, knees, ankles, 
and elbows develop because of changes 
in the tendons and ligaments surround- 
ing the joints, which limit extension. In- 
volvement of the heart and its vessels 
is often severe, with enlarged heart 
and extensive occlusion of the coronary 
arteries.-' 

Diagnosis and treatment 

The diagnosis of Hurler's syndrome, 
initially based on the clinical picture 
and family history, is supported by 

Maureen Spencer Brenchley, a graduate 
of St. Joseph's Hospital school of nursing, 
London, Ontario, was employed as Head 
Nurse of the Metabolic Investigation 
Unit, Children's Psychiatric Research 
Institute in London, when she wrote this 
article for The Canadian Nurse. 



abnormal x-ray findings; it is verified 
by identification of excessive quantities 
of specific mucopolysaccharides, chon- j 
droitin sulphate B and heparitin sul- 
phate, in the urine. A diagnostic spot 
test can be used, but more precise 
assessment is made by isolating and 
characterizing the mucopolysacchari- 
des in a 24-hour urine sample. White 
blood cells and tissue biopsies are also 
examined, and the excessive muco- 
polysaccharides are demonstrable by 
their staining reaction. 

There is no known cure for Hurler's 
syndrome. Research is being done, but 
until more is known, treatment con- 
sists only of alleviating the child's 
symptoms. 

Counseling and nursing care 

On the metabolic investigation unit 
at the Children's Psychiatric Research 
Institute in London, information on 
the likely course of the disease and its 
prognosis is outlined by the physician 
to help the parents accept the situation 
and prepare for the difficult time ahead. 
He may also give genetic counseling. i 

Moral support by our ward staff is 
equally important. Seeing their child 
well cared for by conscientious nurses 
is often the parents' only comfort. 
Nurses accept their expressions of fear 
and grief, listen to them, reassure them 
about everyday care, and refer them 
to the supervisor or physician for more 
detailed information. 

We encourage the child with Hurler's 
syndrome to be as independent as pos- 
sible. We teach him to use the toilet 
and feed and dress himself, according 
to his mental and physical capability. 
If, out of sympathy, a nurse does every- 
thing for him, his condition will deterio- 
rate rapidly. 

Regular skin care is essential, as the 
FEBRUARY 1971 





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53 



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30 



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20 



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Child with Hurler's syndrome. Note ocular hypertelorism, flattened bridge of 
nose, coarse facial features, thick lips, broad tip of nose with flared nostrils, and 
clawhand. Photo on right shows other typical deformities: prominent forehead, 
open mouth, short neck, protuberant stomach, lumbar gibbus, and limitation in 
extension of joints. (Photographs courtesy of Dr. Bruce Gordon, Children's 
Psychiatric Research Institute, London, Ontario.) 



child's skin is dry and coarse and his 
movements are limited. We cleanse 
him frequently and rub him with lotion; 
the creases in his neck and groin tend 
to become irritated and require special 
attention. If the child is bedridden, his 
position is changed hourly to prevent 
decubiti; his limbs are exercised gently 
to lessen the severity of contractures. 

Keeping the child well nourished 
is a challenge to both the nursing and 
the dietary staff. Mouth breathing and 
a constant nasal discharge result in 
a dry, coated tongue and anorexia. To 
increase his appetite we give him fre- 
quent mouth care and sips of water to 
moisten his lips and tongue. 

When feeding the child, we position 
him carefully so he is not doubled up 
FEBRUARY 1971 



with chin on chest. Some of our patients 
sit in a special tilting chair, which 
prevents this "chin-on-chest" position 
during meals. Food of a lumpy consist- 
ency is better than pureed foods to add 
bulk to the child's diet, even though he 
may not be able to chew well because 
of his poor teeth and gums. 

Food is given slowly and in small 
amounts, as there is little space left 
in the child's mouth because of his 
enlarged tongue. With some patients, 
milk increases the viscosity of the al- 
ready abundant mucus in his mouth, 
so it is withheld until the end of the 
meal. Sips of water given after every 
few spoonfuls of food seems to ease 
the child's swallowing difficulties. 

Rather than feeding him hash, we 



try to keep his foods as palatable as 
possible, and allow him to taste indi- 
vidual foods. As the child with Hurler's 
syndrome has so few pleasures to enjoy, 
we do all we can to make his meals 
pleasant and nourishing. 

The child with Hurler's syndrome 
needs sensory stimulation as his deaf- 
ness progresses and his vision dims. 
We hold him, touch him frequently, and 
give him furry toys to play with. We 
play clapping games with him, sing 
loudly to him, and turn up the radio 
or record player so he can hear the 
music. In other words, to use a cliche, 
we give him all the tender loving care 
we can. 

References 

1. Wheeler, Clayton E. Hurler syndrome. 
Textbook of Medicine, ed. P.B. Beeson 
and W. McDermott. Philadelphia, W.B. 
Saunders. 1967, pp.1254-5. 

2. McKusick, Victor A. Heritable disor- 
ders of connective tissue, 3d. ed. Saint 
Louis, Mosby. 1966, p. 328. 

3. Ibid., pp. 329-335. 

Bibliography 

Crawford. S.E. Gargoyllsm. //( Hughes, 
J.G. Synopsis of Pediatrics. Saint Louis. 
Mosby, 1967. p.600-2. 

Danes, B.S., and Beam. A.G. Cellular 
metachromasia, a genetic marker for 
studying the mucopolysaccharidoses. 
Umcet. 1:241. Feb.4. 1967. 

Darfman, A. Heritable disorders of con- 
nective tissue. In Stanbury, J.B. et al. 
The Metabolic Basis of Inherited Dis- 
ease. New York, McGraw-Hill. 1966, 
p.963. 

Nadler. H.L. Medical progress — prenatal 
detection of genetic defects. J. Paediat 
74:132. 1969. § 



THE CANAOyVN NURSE 39 



idea 
exchange 




^'Nursing Communication Act 
Is the Core of Nursing 



The curriculum design of the two-year 
diploma nursing program at Red Deer 
College has been developed with the 
belief that the core of nursing lies in the 
component of the "nursing communica- 
tion act." This philosophy has been 
expressed by Jourard, who says the 
nurse can play the important role in the 
healing process if she can allow the 
patient to be himself, can communicate 
effectively with him, and can make him 
realize his feelings and wishes really 
matter. * 

Although we had this knowledge, we 
still had to determine where and how 
to incorporate it in the educational 
program. Our nursing faculty grappled 
with the problem for some time before 
finding a clue that allowed us to move 
toward our goal. 

We were helped by Maslow, who has 
stated that the real problems of life are 
insoluble ones of death, pain, illness, 
and the like. He believes these problems 
need to be brought out in the open, 
gradually accepted as being insoluble, 
and, whenever possible, enjoyed in 
40 THE CANADIAN NURSE 



their richness and mystery. ** This 
being so, the learner needs to under- 
stand these concerns, relating them 
first to herself and then to the sick in- 
dividual. 

Our educational program is designed 
so the learner is confronted early with 
these existential phenomena, which 
usually become more apparent in ill- 
ness. The student's rapport with patients 
and the effectiveness of her nursing 
communication acts will to some degree 
be influenced by her own ease or dis- 
ease when confronted with these phe- 
nomena of birth, life, death, separation, 
pain, suffering, loneliness, stress, love, 
and hope. 

Jourard has written: "I would like to 
propose that this complex perceptual 
congnitive system — the phenomenal 
field — is the variable which, when 
'integrated' into medical and nursing 
curricula and practice, will bring about 
the outcomes which educators have 
sought, viz., more personalized care 
of patients, more apt diagnoses, and 
more effective therapy." *** 



In our program there are three areas 
of content that proceed simultaneous- 
ly, but at a varying pace. One of the 
areas includes a model of a family 
unit in the community, which provides 
learning situations in a continuum 
throughout the program. The family 
model gives the student an opportunity 
to focus on human growth and develop- 
ment to cover the growth years, main- 
tenance years, and old age; another 
family model emphasizes the maternal- 
child aspects of nursing. 

A second area of content focuses 
on the need to understand self and 
others. Major concepts of mental health 
are studied early in the program. The 
sequence moves toward meeting the 
emotional needs of patients, and allows 
for a breadth of learning situations on 
a continuum from understanding the 
self to the care of the mentally ill as a 
more complex learning experience. 

The learning situations selected for 
nursing communication acts comprise 
diversified experiences. Input through 
readings, reflective thinking, experi- 
mentation with techniques in a class- 
room laboratory situation, and exper- 
ience in clinical settings offer the 
learner opportunities for interpersonal 
relationships and communication on 
an individual and group process basis. 

The third area of content relates to 
the care of the physically ill adult and 
child. General concepts of the pheno- 
menal field are introduced initially, 
after which more specific concepts 
within the area of the phenomenal 



* Sidney ^l. Jourard. The Transparent 
Self. Princeton, D. Van Nostrand Co. 
iJd.. 1967. p. 150. 

** Abraham H. Maslow, Further notes 
on the psychology of being, J. Humanistic 
Psycholofiy 3;1:I20-135, Spring, 1963. 

*'■'* Jourard, op. cit., p. 123 

FEBRUARY 1971 



field, such as body image, sensory de- 
privation, immobility, and stress, are 
discussed for study and applied in all 
clinical settings. 

These concepts lead to the concept 
of illness, and the student then begins 
to grapple with the symptoms of illness. 
The role that drugs and nutrition play 
in alleviating symptoms is also present- 
ed. Technical skills, common to the 
nursing care of all patients and design- 
ed to provide for their fundamental 
needs, are developed. 

One of the basic assumptions of our 
program is that there is a core in nurs- 
ing which is applicable to all clinical 
areas. During the first year, students 
have experience in learning situations 
that include patients requiring long-term 
care; patients with surgical conditions, 
both adults and children; and postpart- 
um mothers. In post-clinical confer- 
ences, students from the various clinical 
areas are assigned to core groups, where 
they compare or contrast the needs 
and the care of patients from their par- 
ticular clinical area. 

In the first year the level of care 
centers around patients who are con- 
valescing or who are moderately ill. 
In the second year the learner moves 
into more complex learning situations 
with patients in the acute phases of 
illness who require either medical or 
surgical intervention. 

In the final semester, situations are 
selected to give the learner an oppor- 
tunity to collaborate with other mem- 
bers of the nursing team. She begins 
to see herself participating not only 
with the patient, but also with his fa- 
mily, the physician, the physiother- 
apist, and other personnel. She sees 
herself as part of a team that works 
together to care for the patient and help 
him reestablish himself to his potential 
level of well-being. — Marguerite E. 
Schumacher, Director, Health and 
Social Services, Red Deer College, 
Red Deer, Alberta. 
FEBRUARY 1971 





00 'VSS-'^^^I 




A Tisket, A Tasket, The Info Is On My Jacket 

A colorful and clever way to help keep young patients' details straight are 
these information jackets made by Charlotte Koolc, graduating class of 
1970, Foothills Hospital School of Nursing. Calgary, Alberta. The bright 
jackets were designed by Miss Koole as part of a pediatric project and seem 
to qualify under the old adage, "a stitch in time. ..." 



THE CANAC^N NURSE 41 



The 

Canadian 
Nurse 

50 The Driveway, Ottawa 4, Canada 




^Z7 



Information for Authors 



Manuscripts 



The Canadian Nurse and L'infirmiere canadienne welcome 
original manuscripts that pertain to nursing, nurses, or 
related subjects. 

All solicited and unsolicited manuscripts are reviewed 
by the editorial staff before being accepted for publication. 
Criteria for selection include : originality; value of informa- 
tion to readers; and presentation. A manuscript accepted 
for publication in The Canadian Nurse is not necessarily 
accepted for publication in L'infirmiere Canadienne. 

The editors reserve the right to edit a manuscript that 
has been accepted for publication. Edited copy will be 
submitted to the author for approval prior to publication. 

Procedure for Submission of 
Articles 

Manuscript should be typed and double spaced on one side 
of the page only, leaving wide margins. Submit original copy 
of manuscript. 

Style and Format 

Manuscript length should be from 1,000 to 2,500 words. 
Insert short, descriptive titles to indicate divisions in the 
article. When drugs are mentioned, include generic and trade 
names. A biographical sketch of the author should accompa- 
ny the article. Webster's 3rd International Dictionary and 
Webster's 7th College Dictionary are used as spelling 
references. 

References, Footnotes, and 
Bibliography 

References, footnotes, and bibliography should be limited 
42 THE CANADIAN NURSE 



to a reasonable number as determined by the content of the 
article. References to published sources should be numbered 
consecutively in the manuscript and listed at the end of the 
article. Information that cannot be presented in formal 
reference style should be worked into the text or referred to 
as a footnote. 

Bibliography listings should be unnumbered and placed 
in alphabetical order. Space sometimes prohibits publishing 
bibliography, especially a long one. In this event, a note is 
added at the end of the article stating the bibliography is 
available on request to the editor. 

For book references, list the author's full name, book 
title and edition, place of publication, publisher, year of 
publication, and pages consulted. For magazine references, 
list the author's full name, title of the article, title of mag- 
azine, volume, month, year, and pages consulted. 

Photographs, Illustrations, Tables, 
and Charts 

Photographs add interest to an article. Black and white 
glossy prints are welcome. The size of the photographs is 
unimportant, provided the details are clear. Each photo 
should be accompagnied by a full description, including 
identification of persons. The consent of persons photo- 
graphed must be secured. Your own organization's form 
may be used or CNA forms are available on request. 

Line drawings can be submitted in rough. If suitable, they 
will be redrawn by the journal's artist. 

Tables and charts should be referred to in the text, but 
should be self-explanatory. Figures on charts and tables 
should be typed within pencil-ruled columns. 

The Canadian Nurse 

OFFICIAL JOURNAL OF THE CANADIAN NURSES' ASSOCIATION 

FEBRUARY 1971 




SELF-USE PREGNANCY TESTING 



SIMPLE .. . four easy steps. 

ACCURATE . . . accuracy is greater than 96%. 

EARLY. . . HCG may be detected aOarly as four days 
after a missed menstrual period. 



[ jTr^'^I^foi-s^gr'/'' '" """" ] Suggested retail price: $5.50 



FEMININE CARE LABORATORIES INTERNATIONAL 

451 Alliance Avenue, Toronto 334, Ontario 



research abstracts 



The following are abstracts of studies 
selected from the Canadian Nurses' 
Association Repository Collection of 
Nursing Studies. Abstract manuscripts 
are prepared by the authors. 



Gorrow, Mary Wranesh. A comparison 
of social atliiiules between freshmen 
and seniors in a collegiate school of 
nursing. Salt Lake City, Utah. 1960. 
Thesis (M.S.) U. of Utah. 

The trend in nursing education has 
been toward increased emphasis on de- 
velopment of the student as an indi- 
vidual, which involves acuteness of 
understanding of herself and others, 
sensitizing her feelings toward others, 
and arousing sympathetic concern for 
others. This implies that the social atti- 
tudes that the student has developed at 
time of entrance into a nursing pro- 
gram may be affected in the educational 
process. 

The present exploratory research 
has attempted to determine if signifi- 
cant differences in social attitudes and 
values are expressed by selected fresh- 
men nursing students and selected sen- 
ior nursing students in a particular 
collegiate school of nursing in a state 
university. The study was predicated 
on the hypothesis that the senior group 
by virtue of the process of education 
and/or maturation would, when tested 
on social attitudes, obtain "higher" 
mean scores, reflecting more liberal 
and critical attitudes and a greater 
degree of tolerance for human weak- 
ness than would the freshmen group. 

A survey of the literature in the field 
disclosed that studies relevant to chan- 
ges in attitudes in students as they 
progressed through the nursing edu- 
cational program were limited in scope 
and number. Since there appeared to 
be no adequate instruments developed 
for testing social attitudes of nurses 
/jer se, a Developmental Status Scale, 
which had emerged from the Mellon 
Foundation Studies at Vassar College 
as discriminating seniors from fresh- 
men on various attitudes, was selected 
for determining whether or not differ- 
ences existed between the nursing 
students. The items were also classified 
into patterns which would disclose 
whether or not there was any differ- 
ence in degree of freedom from com- 
pulsiveness, flexibility and tolerance of 

44 THE CANADIAN NURSE 



ambiguity, impunitive attitudes toward 
others, critical attitudes toward author- 
ity and family, intraception. mature 
interests, unconventionality or non- 
conformity, rejection of traditional 
feminine roles, and freedom from cyn- 
icism toward people. A determination 
of the discrimination value of each 
item was also proposed. 

Statistical analysis was planned to 
test, in null form, the following hypoth- 
eses: 

1. There will be no difference be 
tween the mean score of the senior 
group and the mean score of the fresh- 
man group on the total scale. 

2. There will be no difference be- 
tween the mean scores of the senior 
group and the mean scores of the fresh- 
man group on the classifications of the 
clustered items. 

3. There will be no relationship be- 
tween the correct responses and the 
incorrect responses of the senior group 
and the freshman group on each item. 

The findings indicated that the differ- 
ence in means for the total scale, in the 
direction of the seniors, was signifi- 
cant at the .05 level, thus rejecting the 
first null hypothesis. A significant dif- 
ference, in the direction of the seniors, 
was obtained on four of the thirteen 
classifications. The phi-coefficients ob- 
tained on each item disclosed that the 
responses to only one item demon- 
strated any significant relationship. On 
the basis of the statistical findings, it 
was determined that the seniors achiev- 
ed higher mean scores on a cumulative 
basis rather than on sharply focalized 
differences in social attitudes. 

The senior group demonstrated 
growth in the same direction as did 
Vassar seniors and seniors at other 
colleges where the test had been ad- 
ministered, thus reflecting greater 
degrees of "rebellious independence" 
and tolerance for "human weakness" 
determined as the central themes of the 
scale when it was factor analyzed at 
Vassar College. 

The findings of the study have ob- 
vious implications for the selected 
groups and can be of constructive value 
for the selected school of nursing in the 
evaluation of its educational objectives. 
A foundation for other studies in the 
area of social attitudes of nursing stu- 
dents has been established and several 
recommendations for further research 
are offered. 



Walton, Elizabeth Ann. Hand and arm 

motor behavior in laboring patients. 

New Haven, Connecticut, 1967. 

Thesis (M.Sc.N.) Yale University. 
The purpose of the study was to develop 
and test a tool to measure two compo- 
nents of hand and/or arm motor 
behavior of women in active first 
stage labor. The two components 
were the quantity (frequency) of hand 
and arm movements and the quality 
or nature of, hand activity, specifically 
the presence or absence of muscular 
tension in the hands. These two com- 
ponents were considered indicators of 
body energy depleting activities. 

The study consisted of two phases: 
development of the tool using video 
tapes of women in labor as the source 
of data; checking for clinical validity 
in labor room areas, using the tool to 
measure the hand and arm motor 
behavior of seven mothers. 

The mothers observed in the empir- 
ical setting showed considerable 
individual variation in both the amount 
and nature of hand and arm motor 
behavior. The tool seemed sensitive 
enough to detect variations among 
and within patients. This suggests 
that the two components of hand 
and arm motor behavior may be valid 
indicators of body energy depleting 
activities. 

The mothers exhibited more hand 
and arm movements and more tension 
in the hands during uterine contractions. 
This finding seems to imply that fre- 
quency of hand and arm movements 
and/or tension in the hands may be 
potentially useful indicators of patient 
discomfort. 

Several situational factors and 
patient characteristics were found to be 
associated. Moderate to strong negative 
correlations were found between fre- 
quency of hand and arm movements 
and age of the patient; frequency of 
hand and arm movements and length 
of time the patient was observed; and 
proportion of tension within the hands 
and length of observation time. 

The measurement tool was not 
tested for inter-observer reliability. 
A discussion of the advantages and 
disadvantages of using videotapes as 
a source of data in the development of 
a behavioral measurement tool is in- 
cluded in the implications of the study 
for future research. 

(Continued on page 46) 
FEBRUARY 1971 



Your most important assets - Compassion, 

competence and current complete information. 

Call upon these up-to-date references. 

Creighton: Law Every Nurse Should Know — 2nd Edition 

By Helen Creighton, R.N., B.S.N., A.B., A.M., M.S.N., J.D., 

Professor of Nursing, Univ. of Wis. — Milwaukee 

Here are the legal facts that every nurse should know. Written by 
a nurse who is also a lawyer, this book covers every aspect of the 
law that is important to the nurse, from her obligations as an em- 
ployee to her responsibilities in witnessing a will. The first edition 
became a standard reference and helped thousands of nurses avoid 
legal entanglements. This new edition is substantially larger, including 
such topics as "good samaritan" laws, child abuse, telephone orders, 
sterilization and organ transplantation. 

246 pp. $8.10 June 1970. 

Mayo Clinic Diet Manual — 4tli Edition 

By the Committee on Dietetics of the Mayo Clinic 

Here is the new edition of the most popular and respected dietetic 
guidebook available today. This manual presents hundreds of diets 
to help you plan the meals the doctor orders. Diets are classified 
by disease or disorder. In this edition the Mayo Clinic Food Ex- 
change Lists form the basis for planning most therapeutic diets. 

About 170 pp. About $7.30 Just Ready. 

Cole: The Doctor's Shorthand 

By Frank Cole, M.D., Editor, Nebraska State Medical Journal 

This new manual is a handy guide to medical abbreviations, notations, 
and symbols. Nurses will find it indispensable in reading medical 
records and orders. Nearly 6,000 entries are included; a special 
section defines symbols used in medicine. 

179 pp. Soft cover. $4.90 Oct. 1970. 




Guyton: Basic Human Physiology: 

Normal Function and Mechanisms of Disease 

By Arthur C. Guyton, Univ. of Miss. School of Medicine 

This new book is an ideal size for use by nurses and 
paramedical personnel. It contains a lucid discussion of 
general and cellular physiology, without overwhelming 
detail. 

About 650 pp. Illustrated. About $13.50 Ready March 1971. 



Guyton: Textbook ot Medical Physiology 

By Arthur C. Guyton, Univ. of Miss. School of 
Medicine 

The 4th Edition of this classic medical reference 
presents the body as a single functioning organism 
controlled by a myriad of regulatory systems 
which promote homeostasis. 

About 1100 pp. 757 figs. About $20.00 Just ready. 



W. B. SAUNDERS COMPANY CANADA LTD. 1 835 Yonge Street, Toronto 7, Ontario 




Please send on approval and bill me: 

Author Book title 

Name Address 

City Zone 



CN 2-71 



Proy. 



FEBRUARY 1971 



THE CANADIAN NURSE 45 



Next Month 
in 

The 

Canadian 
Nurse 



• Mind-Body Relationships 
in G.I. Diseases 

• Library Service for 
Shut-Ins 

• Occult Hydrocephalus 
in Adults 



research abstracts 



^ 

^^p 



Photo Credits for 
February 1971 



Royal Alexandra Hospital, 
Edmonton, Alberta, p. 30 

Toronto General Hospital, 
Toronto, Ontario, pp. 33, 34 

Foothills General Hospital, 
Calgary, Alberta, p. 41 



46 THE CANADIAN NURSE 



{Continued from page 44) 

Kerr, Marion. Nursing in fleeting en- 
counters. Montreal, Quebec, 1970. 
Thesis (M. Sc. (App.)) McGill Uni- 
versity. 

Descriptions of nurse-patient inter- 
actions are of concern to nursing as a 
practice discipline in its quest for nur- 
sing theories. This inquiry focused on 
the factors affecting the nurse -patient 
relationship in fleeting encounters for 
a single, specific, predetermined task. 

Nursing was conceptualized as the 
nurse-patient relationship with the 
three observed interaction behavior 
patterns being on a continuum of nurs- 
ing. Data were collected by participant 
observation from two samples of nurse- 
patient interactions that involved 5 
intravenous therapy nurses and 64 
patients, and 3 medication nurses and 
38 patients. 

The critical factor that determined 
the character of the nurse-patient 
relationship was the interrelationship 
among the following three variables 
that emerged: the patient's task-spe- 
cific responses to the nurse's task-spe- 
cific interaction cues, acquaintance of 
the participants in the interaction, and 
the nurse's perception of the serious- 
ness of the patient's illness. 

The finding th^-t different kinds 
of nursing occurred within similar 
periods of time suggested as an area 
for further research nurses' perceptions 
of patient's interaction cues and the 
effects on patients of the nurses' re- 
sponses to these cues in a variety of 
interaction situations. 



Brough, Sylvia. The relationship of the 
faculty members' perception of par- 
ticipation in policy making to their 
perception of the usability of the 
policy. Boston, Mass., 1S66. Thesis 
(M.Sc.N.)U. of Boston. 

The study was undertaken to determine 
whether the faculty members" percep- 
tion of the degree of participation in 
policy-making affects their perception 
of the degree of usability of the policy. 
The data for the study were based on 
information obtained through an opin- 
ionnaire developed by the authors to 
discover the perception of the degree 
of participation in policy-making in 
three selected areas, namely, students, 
curriculum and evaluation, and the 
perception of the degree of usability of 



these policies. Each respondent was 
asked to check the statement that best 
suited her activity in policy-making. 

An opinion inventory developed by 
Sister Michelle Lane was used to as- 
certain the respondents' preference for 
autocratic or democratic administration 
and its effects on their responses. The 
sample consisted of 62 faculty members 
of five schools of nursing in the Greater 
Boston area. 

The findings were as follows: 

1 . There was a statistically signifi- 
cant relationship (p<.05) between the 
perception of the degree of participa- 
tion in formulation and the perception 
of the degree of usability of policies for 
those in the sample who had checked 
all the responses. 

2. No statistically significant rela- 
tionship (p > .05) was found between 
the perception of the degree of partici- 
pation and usability when the sample 
was divided into two groups according 
to their degree of perception of partici- 
pation. 

3. A statistically significant differ- 
ence (p < .05) was obtained in the areas 
related to students, curriculum and 
evaluation. This points to a relation- 
ship between areas with which the 
policies are concerned and perception 
of the degree of participation. 

4. No statistically significant cor- 
relation (p > .05) was obtained in re- 
lation to age, educational qualifications, 
length of experience as a faculty mem- 
ber, length of employment at present 
school, or membership on committees. 

5. A significant correlation was ob- 
tained (p < .05) in relation to the posi- 
tion of a full-time instructor, but no 
significant correlation was found as 
related to the positions of dean or direc- 
tor, assistant dean or director, coordi- 
nator or chairman of program. These 
findings suggest that the position of 
full-time instructor has an effect on her 
perception of degree of participation 
and usability of policies. 

6. All respondents preferred demo- 
cratic administration. When the res- 
pondents were divided in accordance 
with their degree of preference for 
democratic administration, a signifi- 
cant difference (p < .05) was found. 
These findings suggest that a preference 
for democratic administration does 
affect their perception of degree of 
participation and usability of policies. 

The study demonstrated that there 
was a high correlation between the 
perception of the degree of participa- 
tion in policy making and the percep- 
tion of the degree of usability of these 
policies. The variables indicated above 
do have some effect on the respondents' 
replies. Therefore, it is lecommended 
that the study be replicated with larger 
sam-^les and in different geographic 
areas. ■$■ 

FEBRUARY 1971 



The Human Body in Health and Disease, 

3d ed., by Ruth Lundeen Memmler 
and Ruth Byers Rada. 388 pages. 
Toronto, J.B. Lippincott Company, 
1970. 

Reviewed by Roberta M. Ritchie, 
Assistant Director, Inservice Ed- 
ucation, University Hospital, Sas- 
katoon, Sask. 

This book is designed to provide a 
basic introduction to the biological, 
chemical, and physical principles that 
relate to normal and abnormal body 
processes. Throughout the text an 
effort is made to compare the normal 
with the abnormal. 

The first chapter provides a gen- 
eral orientation to body systems, body 
cavities, regions, and directions. An 
overview of disease, disease-producing 
organisms, and disease control is found 
in the second chapter. Chapters three 
to seven discuss basic concepts in cell 
organization, tissue structure and func- 
tions, electrolyte balance, and mainten- 
ance of homeostasis. 

The remainder of the book is organ- 
ized by systems. Each system is dis- 
cussed following the same general pat- 
tern: functions of the system, anatomy 
and physiology of the system, com- 
mon disorders occurring in the sys- 
tem. The book concludes with a chap- 
ter on immunity, allergies, and the re- 
jection syndrome. 

Several features of this publication 
make it a valuable teaching-learning 
tool for the beginning student. The 
sequence of the book proceeds from 
simple to complex concepts. For the 
student who is unfamiliar with medical 
terminology, a pronunciation guide is 
included in parentheses following the 
new terms. In addition, there is a com- 
prehensive glossary and guide to med- 
ical terminology at the end of the 
book. An appendix summarizing bac- 
terial, fungal, viral, and protozoal dis- 
eases and their causative organisms 
provides a quick reference to common 
diseases. The chapters are well illus- 
trated and anatomic plates of the body 
systems give the student a better visual 
orientation of body organs. 

This text provides an integrated 
approach to the study of the human 
body. Its use beyond a basic introduc- 
tory text is limited as the material is 
not covered in any great depth. Even 
as an introductory text the authors 
FEBRUARY 1971 



recognize that it would be essential for 
the student to refer to other books for 
more specific and detailed information. 

Concepts of Depression by Joseph Men- 
dels. 124 pages. New York, John 
Wiley & Sons, Inc., 1970. 
Reviewed by Nessa Leckie, Direc- 
tor of Nursing, Douglas Hospital, 
Verdun, Quebec. 

This volume is one of a series in the 
Wiley Approaches to Behavior Pathol- 
ogy. It is a rather brief, but well-writ- 
ten text, which covers all aspects of 
depression. 

The first section, consisting of three 
chapters, covers clinical syndromes 
with the distinction between bipolar 
(manic depressive symptoms) and uni- 
polar (depressive symptoms) clearly 
stated. Case studies, briefly outlined, 
illustrate the commonly known va- 
rieties of depression and these could 
be useful as teaching tools. 

Following the first three chapters, 
the author considers the psychologi- 
cal theories of Freud, Abraham, Klein, 
Benedek, Bibring, and Arieti as they 
explain .the causes of depression. Sys- 
tematic studies of these theories com- 
plete the overall evaluation. 

Social and cultural studies of factors 
that influence the incidence of depres- 
sion in the western world are limited. 
This chapter is important and high- 
lights the book. 

Completing the picture, the author 
covers biochemical, genetic, and psy- 
chophysiological investigations. A 
chapter on treatment of depressions 
concludes this concise text. The ma- 
terial presented is not new and does 
not add to the present knowledge on 
the subject, but nursing instructors 
should find this book a useful overview 
of the subject, clearly written and easy 
to understand. 

Fifty Years a Canadian Nurse by Rahno 
M. Beamish. 344 pages. New York, 
Vantage Press, 1970. 
Reviewed by Margaret Steed, Ad- 
viser to Schools of Nursing, Uni- 
versity of Alberta, Edmonton, Alta. 

This book is the story of a lifetime of 
dedicated service in the nursing pro- 
fession. 

It is a highly personal account, but 
tells a tale that in many respects must 



have been duplicated by countless 
others. The writer describes many 
experiences during her professional 
life, beginning with her own training 
as a nurse, then as a supervisor of the 
various clinical and specialty areas in 
different hospital situations, as a teacher 
of nurses, an assistant superintendent, 
and superintendent of nurses, culminat- 
ing her career as both an administrator 
and a director of nursing in an ultra- 
modern hospital. Each position and 
experience demanded the utmost in 
ingenuity, courage, and a faith in the 
future. The writer has these qualities 
in abundance, and her story is a saga 
of achievement that holds the attention 
of the reader. 

Miss Beamish has included accounts 
of her family, medical and nursing co- 
workers, students, and friends. She 
comments on their profound influence 
on her career and shows her recogni- 
tion and gratitude for the professional 
and personal associations with each 
during her professional life. 

This book has a special interest for 
those associated with the writer during 
her professional and personal life, 
who will enjoy reminiscing throughout 
the pages. It also has historical value 
as a book written by a Canadian on 
nursing as it was, unfolding experi- 
ences that may be referred to as "home- 
steading in nursing." This book is 
recommended for all who would recall 
that history and share in the inspiration 
it provides. It is also recommended for 
those who enjoy reading books. 

Professional Nursing: foundations, per- 
spectives and relationships. Bed., by 
Eugenia Kennedy Spalding and 
Lucille E. Notter. 677 pages. Toron- 
to, J.B. Lippincott Co. of Canada 
Ltd., 1970. 

Reviewed by Ruth At to, Director of 
Education, School of Nursing, Sher- 
brooke Hospital, Sherbrooke, Que- 
bec. 

The intent and objectives of this edition 
remain the same, and the authors, 
cognizant of the tremendous social 
changes and their impact on nursing, 
have produced an excellent piece of 
work. The text is meant to guide stu- 
dents and graduates to an understanding 
of the major trends and problems 
affecting the profession. 

This edition is considerably changed 
THE CANADlJ^N NURSE 47 




from earlier ones. The book continues 
to be organized into four parts, but the 
chapters have been reorganized to 
present the material in a more logical 
sequence. New chapters have been 
added, one dealing with the responsibil- 
ities for nursing practice, another with 
the American Nurses' Foundation. One 
chapter, "Legal Problems, Responsibil- 
ities and Relationships," has been 
replaced by "Legal Issues in Nursing 
Practice." The authors invited Nathan 
Hershey, a well-known authority on 
nursing and the law, to write this 
chapter. 

The authors have revised, either 
moderately or drastically, one-half of 
the chapters. The illustrations are so 
current that they even include some 
taken at the International Council of 
Nurses' Congress held in Montreal, 
June 1969. 

Several problems are presented to 
the reader following each chapter. These 
provide interesting and challenging 
topics for group discussion and assign- 
ments. The suggested references at the 
end of each chapter are well selected 
and should provide students with more 
than adequate supplemental material. 

I particularly like the chapter on 
public relations in nursing. The authors 
emphasize the need for nurses to be 
aware of their responsibility to the 
public, and show how nurses can inter- 
pret the profession to the public. 

I recommend this text for all libraries 
in institutions that have even a remote 
association with nursing. 

Psychology Principles and Applications, 

5th ed., by Marian East Madigan. 
392 pages. Saint Louis, C.V. Mosby 
Company, 1970. 

Reviewed by Julie Rowney , former- 
ly of the Calgary General Hospital 
School of Nursing, now a candidate 
for an M.Sc. degree in the Depart- 
ment of Psychology , University of 
Calgary, Calgary, Alta. 

The author begins by presenting psy- 
chology as a behavioral science, and 
then discusses heredity and develop- 
ment, with a chapter devoted to the 
needs of the aged and their nursing 
care. The basic psychological content 
encompasses motivation, emotion, 
sensation, perception, learning, and 
measurement. The final chapters deal 
with psychopathology and mental 
health. The glossary, though generally 
adequate, tends to neglect terms asso- 
ciated with behavioristic psychology. 
48 THE CANADIAN NURSE 



The references are limited (usually five 
per chapter) and consider only books. 

Three major criticisms are made of 
the text: 1 . it is over-inclusive to the 
point of inadequate presentation of 
basic psychology; 2. it contains limited 
references, with a total exclusion of 
journal articles; 3. it is not representa- 
tive of current trends in psychology. 

These criticisms are elaborated in 
the following discussion. 

Madigan attempts to give the stu- 
dent information in too many areas of 
the broad field of psychology. As a re- 
sult, the book becomes little more than 
an outline, giving the reader superfi- 
cial content. Also, because of the limit- 
ed reference lists, the book is a poor 
reference source. 

The book could only have utility 
as a basic introductory text. Once stu- 
dents have acquired any sophistication 
in nursing, many of the content areas 
would prove inadequate. For example, 
one of the six sections is concerned 
with growth and development. Gener- 
ally, pediatric nursing texts present a 
more thorough discussion of the area 
than Madigan offers. A similar criti- 
cism can be directed at the section 
dealing with personality disorders and 
mental health. 

Had the author restricted her book 
to basic areas in psychology, the book 
would probably have proven more in- 
formative and useful. Because of the 
elementary nature of the book, its 
applicability to nursing situations is 
questionable. Its major shortcoming is 
in not providing the beginning stu- 
dent with a sound knowledge of behav- 
ior and behavioral interactions. 



Nursing Reconsidered; A Study of 
Change Part 1, by Esther Lucile 
Brown. 218 pages. Toronto, J.B. 
Lippincott Company, 1970. 
Reviewed by Alice Baumgart, Asso- 
ciate Professor, School of Nursing, 
University of British Columbia, 
Vancouver, B.C. 

In the face of an ever-growing cata- 
log of discontents and deficiencies 
with nursing, even the most optimistic 
among us have had cause to wonder 
about the future of the profession. It is 
reassuring, therefore, to find one of 
nursing's long time and loyal friends, 
Esther Lucile Brown, pointing to some 
of the changes taking place and seeing 
in them evidence of a stronger, better- 
defined, and appreciably enlarged role 
for the profession. 

This book, the first of a two-part 
series, is basically an anthology of 
innovative ideas successfully applied 
in hospitals, extended care services, 
and nursing homes. To collect her data, 
Dr. Brown visited various parts of the 



United States and had an opportunity 
to get a first-hand look at settings re- 
flecting the growing technical special- 
ization in nursing and demonstrating 
the trend toward clinical nursing prac- 
tice. Many people she talks about and 
many settings she describes are famil-' 
iar. Among them are Dean Dorothy 
Smith at the J. Hillis Miller Health 
Center at the University of Florida, 
Rosamund Gabrielson at Good Samar- 
itan Hospital in Phoenix, Frances 
Reiter, and the late Lydia Hall at the 
Loeb Center for Nursing and Reha- 
bilitation. 

The author's tone is purposefully 
optimistic for she says, "What is prob- 
ably needed now is not further em- 
phasis upon problems so much as 
attention to the many hopeful develop- 
ments that may permit extensive re- 
organization, both of nursing itself and 
the setting in which it is practiced." 

If Dr. Brown is at all downhearted, 
it is perhaps about intensive care, one 
of the most conspicuous changes of 
the past 10 years. Her particular con- 
cern is well worth noting — that the 
quality of regular nursing service may 
be sacrificed for the very few patients 
served by intensive care units. 

Her greatest enthusiasm is obvious- 
ly for the achievement of a growing 
number ot clmical specialists who have 
succeeded in carving out a patient- 
centered role with the prime object of 
providing comprehensive, continuing, 
and coordinated care. 

To conclude, Dr. Brown presents 
some most interesting thoughts on the 
potential leadership that nursing is 
beginning to assume in meeting the 
health needs of the aged "sick" in nurs- 
ing homes and the aged "well" in 
senior citizens' residences and retire- 
ment homes. 

This is a book that should be widely 
read. Although based on the present, 
its focus is, in effect, on the future. It 
offers innovative ideas for everyone 
of us to consider and, hopefully, try, 
whether we be a general duty nurse or 
a director of a hospital. Equally impor- 
tant, it directs us to take a more posi- 
tive attitude and get on with the busi- 
ness of coping with new realities and 
radical possibilities. 

Disaster Handbook, 2nd ed., by Solo- 
mon Garb and Evelyn Eng. 310 
pages. New York, Springer Publish- 
ing Co., Inc., 1969. 
Reviewed by Evelyn A. Pepper, 
formerly Nursing Consultant, Emer- 
gency Health Services, Dept. Na- 
tional Health & Welfare, Ottawa. 

Since 1964, when the first edition of 
Disaster Handbook was published, 
nurse educators across Canada have 
found it a useful reference text, espe- 
FEBRUARY 197' 



cially in the preparation of lecture ma- 
terial on disaster nursing, now includ- 
ed in the curricula of basic nursing edu- 
cation. Although the original format 
has not been greatly changed in this 
second edition, changes where made do 
enhance the new text. 

The up-dated statistics on various 
types of disasters reveal that the num- 
ber of casualties from most disasters 
has not decreased. Although these star- 
tling statistics apply mostly to the Uni- 
ted States, they may well act as a stim- 
ulus in Canada to mcrease govern- 
mental assistance, expand educational 
programs, generate greater public in- 
volvement, and thus give meaningful 
support to those persons responsible 
for preplanning against any type of 
disaster in this country. 

The expansion of section II, chap- 
ters 14 to 21, relating specifically to 
first aid, makes the handbook more 
complete. Canadian readers will find 
this additional material useful as an 
aide-memoire. But for teaching pur- 
poses, these chapters should not re- 
place the St. John Ambulance Asso- 
ciation's publication First Aid — Ca- 
nadian Edition, used so extensively 
throughout our country in the instruc- 
tion of standard first aid. 

A new chapter, "Astrodemics," has 
been added to section IV. Astrode- 
mics is "a term coined to describe an 
infestation of earth or earth creatures 
by forms of life brought back from 
other celestial bodies." As this has not 
yet occurred on earth, the information 
adds little to the text. The point is 
strongly made however that the possi- 
bility of such disasters occurring is 
much too important to be left with the 
organization related to space admin- 
istration. Future attention and careful 
scrutiny by an impartial agency are 
needed. 

Section IV has a further chapter, 
"Riots and Civil Disturbances," con- 
taining useful information for today 
and, unfortunately, for tomorrow. 

For nurses who do not have the first 
edition of Disaster Handbook, the sec- 
ond edition is highly recommended. 
Replacement of first editions currently 
available in nursing libraries does not 
seem justifiable. ^ 



SHARE YOUR 
GOOD HEALTH 



BE A BLOOD DONOR 







WHICH I.V. 

HAS INFILTRATED? 

Actually we don't know if either I.V. has infiltrated, but 
with the IV-Ometer it is obvious there has been a change 
from the desired flow rate. This change could be from an 
infiltration, the patient lying on the tubing or any of a 
number of causes. 

A flow rate, once established with the "Stay-set" clamp, 
is indicated by placing the marker over the ball. Then, if 
variations occur they can be noted at a glance. The pat- 
ented "Stay-set" clamp assures you that flow variations 
are, indeed, products of something other than the clamp. 

Adaptions are available for use with all I.V. solution con- 
tainers. For further information please complete and mail 
the coupon shown below. 



Gentlemen: Please send more information 

Name 

Address 

City 

State Zip 




Hospital 



Title/Position _^ 

I'V'Ometer P.O. box 1219 SamaCruz, CaNf. 95O6O 



'FEBRUARY 1971 



THE CANADIAN NURSE 49 



AV aids 



FILMS 

IV Additives: Steps to Safety 

Hospital showings of a 15 -minute film- 
strip I.V. Additives: Steps to Safety 
are being offered to doctor, nurse and, 
pharmacist groups by Abbott Labora- 
tories. The showings and distribution 
of a similarly titled booklet are de- 
scribed as part of a new service designed 
to provide helpful data on such addi- 
tives and their compatability. For fur- 
ther information write to Abbott Lab- 
oratories Ltd., P.O. Box 6150, Mont- 
real 101, Quebec. 



A Child and Surgery 

I'm not a Small Adult — Nursing Care 
of the Pediatric Patient in Surgery 
(CS-1066. 16mm. color, sound. 27 
minutes. 1970). The physical and emo- 
tional needs of children are stressed and 
techniques directed al meeting these 
needs arc demonstrated in this film. 
The pediatric surgical patient presents 
problems quite different from those of 
the adult and solutions to these prob- 
lems are provided in this film. Book- 
ings may be made through Davis & 
Gcck Film Library, Cyanamid of Ca- 
nada Limited, P.O. Box 1039. Montreal 
10 L Quebec. 



Operating Room Personnel 

Faces and Phases ofO.R. Management 
(CS-1067. 16 mm. color, 21 minutes. 
1970). This film is centered around 
the multi-disciplinary role the oper- 
ating room supervisor must play. Ac 
centing personnel relationship at all 
levels, the film gives the impression of 
a whirlwind in motion, moving rapidly 
but smoothly and efficiently in a prede- 
termined direction. Available through 
Davis & Geek Film Library. Cyanamid 
of Canada, P.O. Box 1039, Montreal 
101, Quebec. 



Pharmacist on Hospital Team 

Modern Hospital Pharmacy Practice 
(16 mm. color, sound, 20 minutes) 
depicts routines and procedures involv- 
ing the hospital pharmacist as a mem- 
ber of the total health care team includ- 
ing the doctor, the nurse and the social 
worker. The use of the unit dose drug 
distribution system at the City of Hope 
is shown, as well as new developments 
50 THE CANADIAN NURSE 



in clinical pharmacy and the utiliza- 
tion of pharmacy technicians. 

Enquiries should be directed to Dr. 
Allan J. Swartz, Director of Phar- 
macy. City of Hope, 1500 E. Duarte 
Road. Duarte, California. 

TEACHING AIDS 

Heart Sounds and Murmurs 
On Record 

The Art of Heart Auscultation, a new 
12-inch L.P. recording of the Roche 
Scientific Service Series, was prepared 



with the cooperation of Dr. G.W. 
Manning, professor of medicine at the 
University of Western Ontario and 
director of the cardiovascular unit. 
Victoria Hospital, London. 

The record, produced and distrib- 
uted on request by Hoffman-LaRoche 
Limited as a service to the medical 
profession, presents a variety of nor- 
mal and abnormal heart sounds and 
murmurs with corresponding phono- 
cardiographic tracings. The record 
package permits the physician to learn, 
to test his diagnostic skills, or to teach 




Heart Auscultation 



FEBRUARY 197 



auscultation. Physician response to the 
Roche recording included donations 
of $2,400 to the Canadian Heart 
Foundation. 

Write to HotTman-LaRoche Limited, 
1956 Bourdon St., Montreal 378, Que- 
bec for further information. 



Multimedia System 
of Instruction 

LEGS (Learning Experience Guides 
for Nursing Education) is a comprehen- 
sive, multi-media system of individ- 
ualized nursing instruction. By com- 
bining reading, seeing, hearing, dis- 
cussing, and practicing experiences, 
LEGS provides learning objectives 
and motivates students to meet them. 
Orientation for students and instruc- 
tors to the goals and methodology of 
this program of individualized nursing 
education is available in a 1 6mm color, 
sound film. 

LEGS in four volumes is designed for 
use in a two-year technical nursing 
program. Each volume, one for each 
term, is accompanied by its own set 
of audiovisual components. A teacher's 
resource book provides directions on 
how to use the program. 

For an illustrated brochure on LEGS 
or further information, write to the 



marketing manager, educational serv- 
ices, John Wiley & Sons (Canada) Ltd., 
22 Worcester Drive, Toronto, Ontario. 



LITERATURE 



CBC Learning Systems Catalog 

A Canadian Broadcasting Corporation 
audio tape catalog lists signitlcant ma- 
terial originally presented on air as part 
of its broadcast series. 

Tapes in this catalog are available 
on either reels or cassettes and are sold 
on the condition that use of them is 
restricted to non-broadcast, non-com- 
mercial, educational situations only. 
They may not be reproduced in any 
form. 

Among subjects covered in these 
programs are: social perspectives and 
reports, and natural and physical sci- 
ences that may be of interest to nurses. 

One-hour items (on reel or cassette) 
cost $12.00 and 30 minute items, 
$6.00. These prices do not include 
shipping charges. 

The CBC Learning Systems catalog 
of Audio Tapes is available from CBC 
Learning Systems, Box 500, Station 
A, Toronto 1 16, Ontario. 



CONFERENCE MATERIAL 



Vanier Institute Conference Material 
■'Day Care — A Resource for the Con- 
temporary Family" includes papers, 
proceedings, and concluding statements 
of a seminar organized and sponsored 
by the Vanier" Institute in Ottawa, 
September 29 and 30, 1 969 to consider 
day care services as a resource for the 
contemporary family. 

Single copies are available for $1 .50 
from the Vanier Institute of the Fam- 
ily. 151 Slater St.. Ottawa 4, Ontario. 



VIDEOTAPING 



Sony videotape splicing kit 

The new Sony VXK-1 videotape splic- 
ing kit to be used with any 1/2" Sony 
videotape contains everything needed 
for flawless results — precision, splic- 
ing block, tape developer, splicing tape, 
tape cutter, sanitary gloves to prevent 
damage by skin oils to the oxide surface 
of the tape. Illustrated instructions 
include every step from "stop-action" 
editing to the final rewind and allow 
even the novice to achieve perfect 
results. 

iContiniied on page 52) 



THE UNIVERSITY OF CALGARY 



FACULTY POSITIONS 



July openings for faculty positions in a new 
baccalaureate program: two children's nursing; 
one community nursing; and one general (med- 
ical-surgical) nursing. 

Master's degree with major in nursing content 
areas requisite. Preference given to applicants 
with a doctoral degree. Previous teaching and 
nursing practice desirable. Salary negotiable. 



CONTACT: 

Shirley R. Good 
Director, School of Nursing 
The University of Calgary 
Calgary 44, Alberta 
Canada 




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FEBRUARY 1971 



THE CANADIAN NURSE 51 



Further information may be obtained 
from Sony of Canada Ltd., 21 Conneil 
Court, Toronto 18, Ont. -g? 




Publications on this list have been 
received recently in the CNA library 
and are listed in language of source. 

Material on this list, except Reference 
items may be borrowed by CNA mem- 
bers, schools of nursing and other in- 
stitutions. Reference items (theses, 
archive books and directories, almanacs 
and similar basic books) do not go out 
on loan. 

Requests for loans should be made 
on the "Request Form for Accession 
List" and should be addressed to: The 
Library, Canadian Nurses" Association, 
50 The Driveway. Ottawa 4. Ontario. 

No more than three titles should be 
requested at any one time. 

BOOKS AND DOCUMENTS 

1. L'aide medicate en milieu isole par 
Georges Cuvier. Paris, Expansion scientifi- 
que franijaise. 1967. 227p. 

2. Armstrong and Browder's nursing care 
of children 3d ed. by Jean Bulger Mash and 
Margaret Dickens. Philadelphia. F.A. Da- 
vis, 1970. 739p. 

3. Arrows of mercy by Philip Smith. To- 
ronto, Doubleday Canada. 1969. 244p. 

4. The Canadian source book of free educa- 
tional materials, 2d ed. prepared by Cana- 
dian Educational Resources for Teachers. 
Cranberry Portage, Manitoba. Cert. Co., 

1969. 239p. 

5. Careers in nursing edited by John Callag- 
han with a foreword by J. Dunwoody. Lon- 
don, Classic, 1970. 84p. 

6. Challenge to nursing education . . . clini- 
cal roles of the professional nurse. Papers 
presented at the sixth conference of the 
Council of Baccalaureate and Higher Degree 
Programs. Kansas City, National League 
for Nursing, 1970. 47p. 

7. Clinical nursing pathophysiological and 
psychosocial approaches. 2d ed. by Irene 
L. Beland. Toronto, Collier-Macmillan. 

1970. 948p. 

8. Community health nursing practice 
by Ruth B. Freeman. Toronto, Saunders, 
1970. 414p. 

9. Community health services. Prepared 
in consultation with the Committee on Public 
Health Administration, American Public 
Health Association, and a special advisory 
committee by Harold Herman and Mary 
Elisabeth McKay. 2d ed. Wash., Interna- 
tional City Managers" Association, 1968. 
252p. (Municipal management series) 

10. Compendium of pharmaceutical and 
specialties (Canada) prepared by Canadian 
52 THE CANADIAN NURSE 



Pharmaceutical Association. 1971. 930p. 
\\. La contraception hier, aujourd'hui, 
demain, par J. Kahn-Nathan et H. Rozen- 
baum. Paris. LExpansion scientifique 
franeaise, 1969. 238p. 

12. Dans le sillon de la psycho- et de la 
socio-pedagogie; la vie et ses conflits 
sexuels et socio-affectifs par Aurele Saint- 
Yves. Montreal. Renouveau Pedagogique, 
1970. 78p. 

13. La depression nerveuse par Helene Pi- 
lotte. Montreal, Editions de PHomme, 1970. 
207p. 

14. Drugs and solutions; a programmed 
introduction for nurses by Claire Brackman 
and Sybil M. Fletcher. Toronto, Saunders. 
1970. 171p. 

15. Florence Nightingale, nurse to the 
world by Lee Wyndham. New York, World 
Pub. Co., 1969. 175p. 

16. Food values of portions commonly 
used by Anna de Planter Bowes and Church. 
11th ed. rev. by Charles Frederich Church 
and Helen Nichols Church. Toronto, Lip- 
pincott. 1970. 180p. 

17. Fundamentals of neurology. 5th ed. by 
Ernest Dean Gardner. Toronto, Saunders, 
1968. 367p. 

18. Gynecologic et soins infirmiers en gy- 
necologic par Fran?oise Piquette. Montreal, 
Editions du Renouveau Pedagogique, 1970. 
143p. 

19. Home from ho.spital; the results of a 
survey conducted among recently dicharged 
hospital patients by Muriel Skeet. London, 
Dan Mason Nursing Research Committee, 
1970. 91p. 

20. Lc langage de votre enfant; comment 
I'eduquer, le corriger, le developper. Mont- 
real. Editions de PHomme. 1970. 160p. 

2 1 . Measuring your public relations; a 
guide to research problems, methods and 
findings by Herman Stein. New York. Na- 
tional Publicity Council. 1952. 48p. 

22. The measurement of vital signs by 
Russell C. Swansburg. New York, Putman's, 
1970. 408p. 

23. Medsirch: a computerized .system for 
the retrieval of multiple choice items by 
C. B. Hazlett. Developed under the auspices 
of the R. S. McLaughlin Examination and 
Research Centre. Royal College of Physi- 
cians and Surgeons of Canada and Division 
of Educational Research Services, Faculty of 
Education. University of Alberta. Edmonton. 
Division of Educational Research Services, 
University of Alberta, 1970. 65p. 

24. Modern clinical psychiatry . 7th ed. by 
Arthur Percy Noyes, Lawrence C. Kolb. 



Notice 

Frequently, packages of books sent 
from the CNA library to persons liv- 
ing in apartments are returned by the 
post office, marked "not picked up." 
Borrowers are requested to tell their 
apartment superintendent in advance 
that they are expecting books to be 
delivered from the CNA. 



Toronto, Saunders, 1968. 638p. 

25. Naissances planifiees pourquoi? Com- 
ment? par Hubert Charbonneau et 
Serge Mongeau. Montreal, Editions du 
Jour, 1966. 153p. 

26. The national survey of audiovisual 
materials for nursing 1968-1969. Conducted 
by ANA-NLN Film Service, National League 
for Nursing. New York. 1970. 243p. 

27. Occupational health content in bacca- 
laureate nursing education by Marjorie J. 
Keller in association with W. Theodore 
May. Cincinnati. Ohio, U.S. Dept. of 
Health Education and Welfare, Bureau of 
Occupational Safety and Health and Train- 
ing Institute, Office of Training and Man- 
power Development, 1970. 126p. 

28. Pharmacie. 2d. par Yvan Touitow. 
Paris. Masson, 1970. 24 Ip. 

29. Practical nursing; a textbook for students 
and graduates by Dorothy Kelly Rapier et 
al. 4th ed. St. Louis, Mosby, 1970. 647p. 

30. Problemes actuels d'otorhino-laryngo- 
logie par P. Andre et al. Paris. Librairie 
Maloine, 1969. 22 Ip. 

31. La profession d'infirmiere en France. 
N. Wehrlin. redacteur. Paris. Expansion 
Scientifique Fran^aise. 1970. Iv. 

32. Rapport an ministre de la sante et du 
bien-etre social sur les recommandations 
des comites d'etude sur le coiit des services 
sanitaires au Canada. Ottawa. Association 
des Hopitaux du Canada, 1970. Iv. 

33. Reamination et medecine d'urgence, 
1968 sous la direction de M. Goulon et M. 
Rapin. Paris, L"Expansion scientifique 
frangaise, 1968. 367p. (Conferences de rea- 
mination et de medecine d'urgence de PH6- 
pital Raymond Poincare) 

34. Les reunions a I'hopital psychiatrique 
par Denise C. Rothberg. Paris, Centres 
d'entrainement aux methodes d'education 
active. Editions du Scarabee, 1968. 68p. 
(Bibliotheque de Pinfirmier psychiatrique) 

35. Saigner; c'esi vivre le deft quotidien 
par Rachel Gagnon et Jules Lamothe. Chi- 
coutimi, P.Q. Editions science Moderne, 
1970. 161p. 

36. Science year. The world book science 
annual, 1970. Chicago, Field Enterprises 
Educational Corp. 441 p. 

37. Teach in sur la sexualile par Helene 
Pilotte. Montreal. Editions de PHomme, 
1970. 172p. 

38. Teaching the operating room techni- 
cian; written and compiled by the Tech- 
nician Manual Committee of the Associa- 
tion of Operating Room Nurses, Margaret 
A. Burns et al. New York, Association of 
Operating Room Nurses. Technician 
Manual Committee. 1967. 337p. 

39. Operating room topics; an anthology of 
selected articles from AORN journal. N.Y., 
1968. 264p. 

40. Technical nursing of the adult; medical, 
surgical and psychiatric approaches by 
Sandra B. Fielo and Sylvia C. Edge. Toronto, 
Collier-Macmillan, 1970. 588p. 

41. Urologic nursing by John G. Keuhne- 
lian and Virginia E. Sanders. Toronto, 
Collier-Macmillan, 1970. 407p. 

FEBRUARY 1971 



PAMPHLETS 

42. Collcf^c etiiaalion: key lo a professional 
career in nursing. New York. National 
League for Nursing. Dept. of Baccalaureate 
and Higher Degree Programs, 1970. I9p. 

43. Costs and time analysis of monograph 
cataloging in hospital libraries: a preliminary 
stiuly by Linda Angold. Detroit. 1969. 22p. 
(Wayne State University. School of Medicine. 
Library and Biomedical Information Series 
Center. Report no. 5 1 ) 

44. Developing and using performance 
standards by Constance M. Ewy. Washington. 
Society for Personnel Administration. 1962. 
27p. 

45. Diagnosis of hospital assault: presented 
by Lome Elkin Rozovsky at annual meeting 
of the Nova Scotia Hospital Association 
at Halifax on Oct. 30. 1969. Halifax 1969. 
29p. 

46. Folio of reports. Quebec. Association of 
Nurses of the Province of Quebec. 1970. 42p. 

47. Manuel de la .secretaire medicale et de 
la receptionniste par Rolland Gagne. Mont- 
real. Editions Intermonde. 1969. 40p. 

48. Nursefacuity census 1970. New York. 
National League for Nursing. 1970. 9p. 

49. Pertinent points for presidents and a 
glo.s.sary of terminology for all by Orlea 
Alden. Vancouver. B.C.. 1970. 18p. 

50. The prevention of rheumatic fever 
and rheumatic heart diseases. New York. 
Inter-Society Commission for Heart Disease 
Resources. Rheumatic Fever and Rheumatic 



Heart Disease Study Group. 1970. 34p. 

51. Report 1969. Toronto. Canadian Mental 
Health Association. 1970. 16p. 

52. Report. 1970. London. Royal College 
of Nursing and National Council of Nurse 
of the United Kingdom. 1970. 63p. 

GOVERNMENT DOCUMENTS 

Canada 

53. Bureau of Statistics. Estimated popula- 
tion of Canada by province at June I, 1970. 
Ottawa. Queen's Printer. 1970. 2p. 

54. — . Hospital statistics. Preliminary 
anmud report, 1969. Ottawa. Queens 
Printer. 1970. 37p. 

55. — . Mental health statistics, vol. I, 
Institutional admissions and separations, 

1969. Ottawa. Queens Printer. 1970. 196p. 

56. — . Salaries and qualifications of teach- 
ers in universities and colleges, 1969170. 78p. 
57- — • Survey of higher education, pt. 
I: Fall enrolment in universities and 
colleges 1969-70. Ottawa. Queen's Printer. 

1970. 173p. 
1970. 173p. 

58. — . Vital statistics 1968. Ottawa. 
Queen's Printer. 1970. 248p. 

59. Dept. of Labour. Economics and 
Research Branch, mige rates, .salaries and 
hours of labour, 1969. Ottawa. Queens 
Printer. 1970. 436p. 

60. — . Legislation Branch. /.<;/)<«//• .s7«/it/(;r(/.s 
/" Canada. 1969. Ottawa. Queen's Printer. 
1970. 98p. 



61. — . Women's Bureau. Facts and figures 
about women in the labour force, 1969. 
Ottawa. 1970. 19p. 

62. Dept. of Manpower and Immigration. 
Requirements and average starting salaries: 
community college graduates. Ottawa. 
Queen's Printer. 1970. 15p. 

63. — . Requirements and average starting 
.salaries: university gradtuites. Ottawa, 
Queen's Printer. 1970. 21p. 

64. Dept. of National Health and Welfare. 
Research projects 1970. Ottawa. 1970. 125p. 

65. — . Emergency Welfare Services Divi- 
sion. Registration and inquiry manual. 
Ottawa. Queen's Printer. 1969. 73p. 

66. — . Research and Statistics Directorate. 
The measurement of poverty. Ottawa. 1970. 
45p. (Its Social Security Series. Memoran- 
dum no. 19) 

Ontario 

67. Dept. of Health. 
Toronto. 1970. 187p. 

68. — . Stillbirths in 
Toronto. 1970. 14p. 
no.47) 
United States 

69. Dept. of Health. Education and Welfare. 
Public Health Service. Smokers' self-testing 
kit. Washington, U.S. Gov't Print. Off.. 
1969. lip. (U.S. Public Health Service. 
Publication 1904 (rev.)) 

70. Public Health Service. National In- 
stitutes of Health. Nursing personnel in 
hospitals, 1968. Wash. U.S. Gov't. Print. 
Off.. 1970. 382p. 'g? 



Report, 45th. 1969. 

Ontario 1921-1967. 
(Its Special Report 



Request Form for "Accession List" 
CANADIAN NURSES' ASSOCIATION LIBRARY 

Send this coupon or facsimile to: 

LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario 

Please lend me the following publications, listed in the issue of The 

Canadian Nurse, or add my name to the waiting list to receive them when available: 

■tern Author Short title (for identification) 

No. 



Requests for loans will be filled in order of receipt. 

Reference and restricted material must be used in the CNA library. 

Borrower Registration No. 

Position 



Address 

Date of request 



FEBRUARY 1971 



THE CANADMN NURSE 53 



February 15-19, 1971 

Occupational Health Nursing course, spon- 
sored by the University of Toronto. De- 
signed for registered nurses with at least 
five years experience in occupational 
health nursing who work alone or with one 
other nurse. For more information, contact 
the University of Toronto. 

February 16-18, 1971 

First National Conference on Research 
in Nursing Practice, Skyline Hotel. Ottawa. 
Purpose of this bilingual conference is to 
stimulate research in nursing practice. 
Registration is limited to 200. Fee: $10 
per day: $5 per day for nurses enrolled in 
graduate programs. For further information 
and registration forms, write to: Dr. Floris 
E King. Project Director. School of Nursing, 
University of British Columbia. Vancouver 
8. B.C. 

March 15-16, 1971 

Workshop on Rituals and Routine, spon- 
sored by the New Brunswick Association 
of Registered Nurses, Fredericton, N.B. 
Leader of this workshop for head nurses 
will be Pamela E. Poole, nursing consultant. 
Hospital Insurance and Diagnostic Services, 
Department of National Health and Welfare. 

March 31, 1970 

Canadian Nurses' Association annual 
meeting, business sessions only, Chateau 
Laurier, Ottawa, Ontario. 

April 19-22, 1971 

Canadian Public Health Association, 62nd 
annual meeting. King Edward Sheraton 
Hotel, Toronto. For advance registration, 
information, and accommodation, write: 
CPHA Annual Meeting, 1255 Yonge Street, 
Toronto 7, Ontario. 

May 9-12, 1971 

National League for Nursing and National 
Student Nurses' Association, annual con- 
vention, Dallas (viemorial Auditorium and 
Convention Hall, Dallas, Texas, U.S.A. 

May 10-14, 1971 

Ontario Medical Association, annual meet- 
ing. Royal York Hotel, Toronto, Ontario. 



May 11-14, 1971 

Alberta Association of Registered Nurses, 

annual meeting, Banff Springs Hotel, Banff, 

Alberta. 

54 THE CANADIAN NURSE 



May 19, 1971 

Catholic Hospital Conference of Ontario, 
nursing committee, annual meeting. King 
Edward Hotel, Toronto, Ontario. 

May 20-21, 1971 

Catholic Hospital Conference of Ontario, 
annual meeting. King Edward Hotel, Toron- 
to. Ontario. 

May 26-29, 1971 

Reunion of The Montreal General Hospital 
School of Nursing graduates to celebrate 
the hospital's 150th anniversary. Graduates 
should send addresses to; Miss Phyllis 
Walker, The Montreal General Hospital 
{Dept. of nursing), Montreal 109, P.O. 

May 30-June 1,1971 

Manitoba Association of Registered nurses, 
annual meeting, Dauphin, Manitoba. 

May 31-|une 1,1971 

Catholic Hospital Association, annual con- 
vention, Montreal. Convention chairman: 
Rev. Sister Bernadette Poirier, Director of 
Nursing, Notre Dame Hospital, Montreal. 

May31-)une3, 1971 

Canadian Tuberculosis and Respiratory 
Disease Association and Canadian Thoracic 
Society, annual meetings. King Edward 
Sheraton Hotel, Toronto. Further details on 
request to Dr. C.W.L. Jeanes, Executive 
Secretary, 343 O'Connor Street, Ottawa 4. 



June 6-10, 1971 

Ninth Canadian Cancer Conference under 
the auspices of the National Cancer Ins- 
titute of Canada, Honey Harbour, Ontario. 

June 6-12, 1971 

Annual Meeting, Canadian Medical As- 
sociation, Halifax, N.S. For further informa- 
tion write: Canadian Medical Association, 
1867 Alta Vista Drive, Ottawa 8, Ont. 



June 7-11, 1971 

Canadian Medical Association, 104th an- 
nual meeting. Nova Scotia. For further 
information: Mr. B.E. Freamo, Acting 
General Secretary, Canadian Medical 
Association, 1867 Alta Vista Drive, Ottawa 
8, Ontario. 

June 7-11, 1971 

Catholic Hospital Association (U.S.), 56th 
annual convention, Atlantic City, New 
Jersey. 



June 9-12, 1971 

Canadian Psychiatric Association, annual 
meeting. Lord Nelson Hotel, Halifax, Nova 
Scotia. 

June 21-24, 1971 

Canadian Society of Radiological Techni- 
cians, 29th annual national convention. 
Holiday Inn, St. John's, Newfoundland. 



June 1971 

Special Reunion of the Alumnae of Ontario 
Hospital Brockville School of Nursing, in 
conjunction with the last graduation from 
the School of Nursing. Send addresses to 
Nurses' Alumnae, Box 1050, Brockville, Ont. 



June 1971 

Canadian Association of Neurological 
and Neurosurgical Nurses, second annual 
meeting. St. John's. Newfoundland. For 
further information contact the Secretary: 
Mrs. Jacqueline LeBlanc, 5785 Cote des 
Neiges, Montreal 209, Quebec. 



June 2-4 1971 

Canadian Hospital Association, National 
convention and assembly. Queen Elizabeth 
Hotel, Montreal, Quebec. 



July 12-16, 1971 

Twenty-first International Tuberculosis 
Conference, The Palace of Congresses, the 
Kremlin, Moscow, Russia. Simultaneous 
translation into English, French, German, 
and Russian will be provided. 



July 13-19, 1971 

International Hospital Federation Con- 
gress, Dublin, Ireland. 

November 28-Deceniber 4, 1971 

World Psychiatric Association, Fifth World , 
Congress of Psychiatry, Mexico City. For ' 
further information, write Secretariado Del 
"V" Congresso, Mundial de Psiquiatria, 
Apartado Postal 20-123/24, Mexico, D.F. 

May 13-19,1973 

International Council of Nurses, 15th Quad- | 
rennial Congress, Mexico City, Mexico. ■& 
FEBRUARY 1971 



Index 

to 

advertisers 

February 1971 



Abbott Laboratories Ltd 9 

Burroughs Wellcome & Co. (Canada) Ltd 23 

Clinic Shoemakers 2 

Denver Laboratories (Canada) Ltd 43 

Charles E. Frosst & Co 20 

LV. Ometer 49 

Johnson & Johnson Limited 17, 24 

J.B. Lippincott Company of Canada Limited 1 

Octo Laboratory Ltd 6 

J.T. Posey Company 5 

Professional Tape Co., Inc 16 

Reeves Company Cover IV 

W.B. Saunders Company Canada Ltd 45 

Schering Corporation (Canada) Limited 13 

Julius Schmid of Canada Ltd 1 1 

White Sister Uniform, Inc Cover II, Cover III 

Winley-Morris Company Ltd 51 



Advertising 

Manager 

Ruth H. Baumel, 

The Canadian Nurse 

50 The Driveway 

Ottawa 4, Ontario 

Advertising Representatives 
Richard P. Wilson 
219 East Lancaster Avenue 
Ardmore, Penna. 19003 

Vanco Publications, 
2 Tremont Crescent 
Don Mills, Ontario 

Member of Canadian 
Circulations Audit Board Inc. 



ima 



the word is 



OPPORTUNITY 

for Registered Nurses in tlie medical 
centre of Atlantic Canada 




Opportunity for professional growth 
Opportunity for advancement 
Opportunity for specialization 

if you are a registered nurse looking for nev\^ 
horizons where you can fulfill the aspirations of 
your nursing profession in the challenging 
atmosphere of a large, progressive, teaching hospital 
. . . join us at the Victoria General. Our need 
is your opportunity. There are excellent general 
staff openings in Medicine, Neuro-surgery, Surgery, 
Recovery Room, Emergency and Operating Room 
and Intensive Care Units. Excellent salary and 
benefits with additional credit for experience and 
skills learned in special units. You will enjoy 
living in Nova Scotia with its almost unlimited 
recreational opportunities and temperate climate. 
We'll be glad to send you more information. 

Write: D.R. Miller 

Personnel Officer 

VICTORIA GENERAL HOSPITAL 

Halifax, Nova Scotia 



FEBRUARY 1971 



THE CANADIAN NURSE 71 



PROVINCIAL ASSOCIATIONS OF REGISTERED NURSES 



Alberta 

Alberta Association of Registered Nurses. 
10256 — 1 12 Street. Edmonton. 
Pres.: M.G. Purcell; Pics.-Elcct: R. Erick- 
son; yice-Pres.: D.E. Huffman. A.J. Prowse. 
Committees — Nnrs. Sen.: G. Clarke: 
Niir.s. Ediic: G. Bauer; Staff Nurses: L.A 
Meighen; Siiperv. Nurses: L. Bartlett: Soc. 
& Econ. Welf.: 1. Mossey. Provincial Office 
Staff— Pith. Rcl.: D.J. Labelle: Employ. 
Rel.: Y. Chapman; Committee Advisor: 
H. Cotter; Registrar: D.J. Price; E.xec. Sec: 
H.M. Sabin; Office Manager: M. Garrick. 

British Columbia 

Registered Nurses" Association of British 
Columbia. 2130 West 12th Avenue. Vancou- 
ver 9. 

Pres.: M.D.G. Angus; Past Pres.: M. Lunn; 
Vice-Pres.: R. Cunningham. A. Baumgart; 
Hon. Treasurer: T.J. McKenna; Hon. Sec: 
Sr. K. Cyr. Committees — Nurs. Educ: 
E. Moore; Nurs. Serv.: J.M. Dawes; Soc. 
& Econ. Welf: R. Mcfadyen; Finance: 
T.J. McKenna; Leg. & By-Laws: Norman 
Roberts; Pub. Rel.: H. Niskala; Exec. Di- 
rector: P. A. Kennedy; Registrar: H. Grice; 
Communications Consult.: C. Marcus. 

Manitoba 

Manitoba Association of Registered Nurses. 
647 Broadway Avenue, Winnipeg 1. 
Pres.: M.E. Nugent; Past Pres.: D. Dick; 
Vice-Pres.: F. McNaught. Sr. T. Caston- 
guay. Committees — Nurs. Serv.: J. Robert- 
son; Nurs. Educ: S.J. Winkler; Soc. & Econ. 
Welf: S.J. Paine; Legis.: M.E. Wilson; Ac- 
crediting: ME. Jackson; Board of Examiners: 
E. Cranna; Ediu: Fund: M. Kullberg; Fi- 
nance: B. Cunnings; Pub. Rel. Officer: T.M. 
Miller; Registrar: M. Caldwell; Exec. Di- 
rector: B. Cunnings; Coordinator of Conlin. 
Educ: H. Sundstrom. 

New Brunswick 

New Brunswick Association of Registered 
Nurses. 2.3 1 Saunders Street, Fredericton. 
Pres.: H. Hayes; Past Pres.: I Leckie; Vice- 
Pres.: A. Robichaud, L. Mills; Hon. Sec: 
M. MacLachlan. Committees — Soc. & Econ. 
Welf: B. Leblanc; Nurs. Educ: Sr. H. Ri- 
chard; Nurs. Serv.: Sr. M.L. Gaffney; Fi- 
nance: A. Robichaud; Legisl.: M. MacLach- 
lan; Exec. Sec: M.J. Anderson; Acting 
Registrar: M. Russell; Adv. Com. to Schools 
of Nurs.: Sr. F. Darrah; Nurs. Asst. Comm.: 
A. Dunbar; Liaison Officer: N. Rideout; 
Employ. Rel. Officer: G. Rowsell. 

Newfoundland 

Association of Nurses of Newfoundland, 
67 LeMarchand Road, St. John's. 
Pres.: P. Barrett; Past Pres.: E. Summers; 
Pres. Elect.: E. Wilton; 1st Vice-Pres.: J. 
Nevitt; 2nd Vice- Pres.: E. Hill; Committees 
— Nurs. Educ: L. Caruk; Nurs. Serv.: A. 
Finn; Soc. <t Econ. Welf.: L. Nicholas; 
72 THE CANADIAN NURSE 



Exec Sec: P. Laracy; Asst. Exec. Sec: M. 
Cummings. 

Nova Scotia 

Registered Nurses" Association of Nova 
Scotia, 603.5 Coburg Road. Halifax. 
Pres.: J. Fox; Past Pres.: J. Church; Vice- 
Pres.: Sr. C. Marie, M. Bradley, E.J. Dob- 
son; Advisor, Nurs. Educ: Sr. C. Marie; 
Advi.sor. Nurs. Serv.: J. MacLean. Com- 
mittees — Nurs. Educ: Sr. J. Carr; Nurs. 
Serv.: G. Smith; Soc. & Econ. Welf: Roy 
Harding; Exec. Sec: F. Moss; Pah. Rel. Of- 
ficer: G. Shane; Employ. Rel. Officer: M. 
Bentley. 

Ontario 

Registered Nurses" Association of Ontario. 
33 Price Street, Toronto 289. 
Pres.: L.E. Butler; Pres. Elect: M.J. Flaherty. 
Committees — Socio.-Econ. Welf: M.E.B. 
Purdy; Nursing: E. Valmaggia; Educator: 
A.E. Griffin; Administrator: M.A. Liddle; 
Exec. Director: L. Barr; Asst. Exec. Di- 
rector: D. Gibney; Employ. Rel. Director: 
A.S. Gribben; Coord.. Formal Contin. Educ 
Program: L.C. Peszat; Director. Prof. Devel. 
Dept.: CM. Adams; Pub. Rel. Officer: I. 
LeBourdais; Regioiuil Exec. Sec: l.W. 
Lawson. M.l. Thomas. F. Winchester. 

Prince Edward Island 

Association of Nurses of Prince Edward 
Island, 188 Prince Street, Charlottetown. 
Pres.: C. Corbett; Past Pres.: B. Rowland; 
Vice-Pres.: B. Robinson; Pres. Elect.: E. 
MacLeod. Committees — jV((rv. Educ: 
M. Newson; Nurs. Serv: S. Griffin; Pub: 
Rel.: C. Gordon; Finance: Sr. M. Cahill; 
Legis. & By-Laws: H.L. Bolger; Soc. & 
Econ. Welf: F. Reese; Exec. Sec- Registrar: 
H.L. Bolger. 
Quebec 

Association of Nurses of the Province of 
Quebec. 4200 Dorchester Boulevard. West, 
Montreal. 

Pres.: H.D. Taylor; Vice Pres.: (Eng.j S. 
ONeill, R. Atto; iFr.): R. Bureau, M. La- 
lande; Hon. Treas.: J. Cormier; Hon. Sec: 
R. Marron. Committees — Nurs. Educ: 
M. Callin, D. Lalancette; Nurs. Serv.: E. 
Strike, C. Gauthier; Labor Rel.: S. O'Neill. 
G. Hotte; School of Nurs.: M. Barrett. P. 
Proveni;al; Legis.: E.C. Flanagan. G. (Char- 
bonneau) Lavallee; Sec-Registrar: N. Du 
Mouchel. 
Saskatchewan 

Saskatchewan Registered Nurses Association, 
2066 Retallack Street. Regina. 
Pres.: M. McKillop: Past Pres.: A. Gunn; 
1st Vice-Pres.: E. Linnell; 2nd Vice-Pres.: 
C. Boyko. Committees — Nurs. Educ: C. 
0"Shaughnessy; Nurs. Serv.:]. Belfry; Chap- 
ters & Pub. Rel.: M. Harman; Soc. & Econ. 
Welf: E. Fyffe; Exec. Sec: A. Mills; Reg- 
istrar: E. Dumas; Employ. Rcl. Officer: A. 
M. Sutherland; Nurs. Consult.: E. Hartig; 
A.\sl. Registrar:}. Passmore. 



yV CANADIAN 

\yr^ NURSES' 



ASSOCIATION 



Board of Directors 

President E. Louise Miner 

President-Elect 

Marguerite E. Schumacher 

1st Vice- President 

Kathleen G. DeMarsh 

2nd Vice-President 

Huguette Labelle 

Representative Nursing Sisterhoods 

...Sister Cecile Gauthier 
Chairman of Committee on Social & 

Economic Welfare ..Marilyn Brewer 
Chairman of Committee on 

Nursing Service ...Irene M. Buchan 
Chairman of Committee on Nursing 
Education Alice J. Baumgart 



Provincial Presidents 

AARN M.G. Purcell 

RNABC M.D.G. Angus 

MARN M.E. Nugent 

NBARN H. Hayes 

ARNN P. Barrett 

RNANS J. Fox 

RNAO L.E. Butler 

ANPEI C. Corbett 

ANPQ H.D. Taylor 

SRNA M. McKillop 



National Office 

Executive 

Director Helen K. Mussallem 

Associate Executive 

Director Lillian E Pettigrew 

General 

Manager Ernest Van Raalte 



Research and Advisory Services 

Nursing 
Coordinator Harriett J.T. Sloan 

Research Officer H. Rose Ima: 

Library Margaret L. Parkin 

litformation Services 

Public Relations Doris Crowe 

Editor. The Canadian 

Nurse Virginia A. Lindabury 

Editor. L"infirmiere 

canadienne Claire Bigue 



FEBRUARY 1971 



March 1971 






VL* 



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The 



Canadian 
Nurse 





mind-body relationships 
in gastrointestinal diseases 



health is everybody's business 



occult hydrocephalus 
in adults 




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Asperheim: PHARMACOLOGY FOR PRACTICAL NURSES 

Third Edition 

By Mary Kaye Asperheim, B.S., M.S., R.Ph., M.D. 

A new edition of this outstandingly useful text. The author discusses drugs 
in relation to body systems and their diseases; she describes the physical 
forms of the drugs, the usual dosage, methods of administration, symptoms 
of overdosage, and abnormal reactions which may arise. This third edition 
includes a chapter on antineoplastic drugs, and the drug descriptions and 
dosages reflect the latest research. 

About 208 pages, illustrated. About $3.80. Just ready. 



Kron: MANAGEMENT OF PATIENT CARE 

Putting Leadership Skills to Work Third Edition 

By Thora Kron, R.N., B.S. 

Shows the professional nurse the many ways she can exercise leadership 
in the management of patient core. Includes methods to help the nurse 
become more efficient in arranging supplies and equipment, in studying 
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of the health care team, and in planning her own activities. 

About 208 pages, illustrated. About $3.80. Just ready 



MAYO CLINIC DIET MANUAL 

Fourth Edition 

By the Committee on Dietetics of the Mayo Clinic 

Here is the new edition of the most popular and respected dietetic guide- 
book available today. This manual, developed for use at the Mayo Clinic 
and its associated hospitals, has been revised and expanded to embody 
the latest information on nutrition and dietary management. The Mayo 
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peutic diets. 

166 pages, soft cover. $6.45. Published January, 1971. 



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Please send on approval and bill me: 

D Asperheim: Pharmacology for Practical Nunei (about $3.80) 
n Kron: Management of Patient Care (about $3.80) 
D Mayo Clinic Diet Manual ($6.45) 

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MARCH 1971 



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CN 3-71 

THE CANADIAN NURSE 1 






Next 

to your 

face 

the most comfortable 

thing is a new 

SURGINE* 

mask 




Johnson & Johnson's newly developed SURGINE Face 
Mask — six years in the designing — is so extra- 
ordinarily comfortable you'll be almost as unaware of 
it as you are of your own skin. 

The fact that the SURGINE mask fits so well is part of the 
reason it does such a superior job of bacterial filtration. 
Cheek and chin leaks are eliminated. But the main 



reason for SURGINE's efficiency is a new, specially 
developed filter medium. In vivo tests show an extra- 
ordinary average filtration efficiency of 97% . 
For free samples of the new SURGINE Face Mask, con- 
tact your Johnson & Johnson representative. Or write to 
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'Trademark of Johnson & Johnson or affiliated companies. 



THE CANADIAN NURSE 



SURGINE 

the comfortable face mask 

MONTREAL4TORONTO- CANADA 



MARCH 1971 



The 

Canadian 
Nurse 



^ 

^^p 



A monthly journal for the nurses of Canada published 

In English and French editions by the Canadian Nurses' Association 



Volume 67, Number 3 



March 1971 



31 Health is Everybody's Business Virginia Henderson 

35 Mind-Body Relationships in 

Gastrointestinal Disease D.J. Buchan 

38 Care of Patients with G.I. Diseases That Have 

a Psychological Component G. Mowchenko 

41 Idea Exchange V. Millen 

42 Auditors' Report and Financial Statement for CNA 

46 Information for Authors 

47 Occult Hydrocephalus in Adults C. Shick, E. Yallowega 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 



4 


Letters 


7 


News 


18 


Names 


22 


New Products 


26 


Dates 


28 


In a Capsule 


51 


Research Abstracts 


52 


Books 


53 


AV Aids 


54 


Accession List 


71 


Index to Advertisers 


72 


Official Directory 



Executive Director: Helen K. Mussallem • 
Editor: Virginia A. Lindaburt • Assistant 
Editor; Liv-Ellen Lockeberg • Production 
Assistant: Elizabeth A. Stanton • Circula- 
tion Manager: Ber>l Darling • .Advertising 
Manager: Ruth H. Baumel • Subscrip- 
tion Rates: Canada: one year, $4.50; two 
years, $8.00. Foreign: one year, $5.00; two 
years, $9.00. Single copies: 50 cents each. 
Make cheques or money orders payable to the 
Canadian Nurses' Association. • Change of 
Address: Six weeks' notice; the old address as 
well as the new are necessary, together with 
registration number in a provincial nurses' 
association, where applicable. Not responsible 
for journals lost in mail due to errors in 
address. 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced. 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in India ink on white paper) 
.ire welcomed with such articles. The editor 
is not committed to publish all articles 
sent, nor to indicate definite dates of 
publication. 

Postage paid in cash at third class rate 
MONTREAL. P.O. Permit No. 10,001. 
50 The Driveway. Ottawa 4, Ontario. 
O Canadian Nurses' Association 1971. 



Editorial 



MARCH 1971 



A coroner's jury, inquiring into the 
death of a hospitalized patient two 
days after dental surgery, criticized 
both doctors and nurses: the doctors 
for not being available after the patient's 
surgery, the nurses for not listening 
to the patient's relative. 

Apparently the nurses tried in vain 
to get in touch with the dentist who 
performed the surgery and the physi- 
cian who examined the patient preoper- 
atively. One nurse told the coroner's 
jury she did not believe the patient's 
condition was serious enough to warrant 
calling in a doctor from the emergency 
ward. The patient's sister testified she 
had asked the nurses several times to 
call a doctor, and finally tried to call 
one herself 

Although evidence showed the pa- 
tient would have died even if she had 
received medical treatment, the jury 
made this astounding recommendation: 
Nurses should carefully consider the 
concerns of relatives or friends who 
may, from long personal contact, have 
a better knowledge of a patient's change 
in condition. 

Why is this recommendation astound- 
ing? Because a coroner's jury felt com- 
pelled to make it. 

All of us, from the time we enter 
schools of nursing until we put our cap 
on the shelf, are made aware of the 
important role played by the patient's 
relatives in his overall treatment. Some- 
how, however, we have failed to put 
our awareness into practice. True, we 
are pleased when our patient has visi- 
tors, as we know they are good for his 
morale; we try to keep his relatives 
informed and involve them in his 
care; and we are sympathetic when a 
patient has died or is about to die. 

But do we really listen to these 
relatives and friends when they express 
concerns, such as the patient's dislike 
of certain foods, his inability to tolerate 
drugs he is receiving, his loneliness, 
or a change in his condition that they 
recognize because they know him so 
well? Or do we brush aside these con- 
cerns, believing we are dealing with 
troublesome visitors who are trying to 
interfere with the care we believe is 
best? 

Patients' relatives and friends have 
much to tell us. And until every nurse 
recognizes this, our profession can be 
justly accused of paying lip service 
only to our oft-repeated philosophy 
that each patient has a right to receive 
total, personalized nursing care. 

— V.A.L. 
THE CANADIAN NURSE 3 



letters 



Letters to the editor are welcome. 

Only signed letters will be considered for publication, but 

name will be withheld at the writer's request. 



Nurses form social club 

A Nurses' Social Club has been formed 
in Montreal with the aim of arranging 
social, recreational, and travel activ- 
ities. The club is in its infancy and we 
are endeavoring to publicize it and so- 
licit interest. Membership in this bi- 
lingual organization is open to nurses 
across Canada, their families, and 
friends. Local chapter meetings will be 
held monthly. 

The initial group was formed by 
four nurses in September. At present 
there are no membership dues, but a 
small due will be levied if our group 
travel facilities are utilized. 

Officers are: president, Isabelle 
Adams; vice-president, Victoire Audet; 
treasurer, Gaetane Pageau; secretary 
and public relations officer, Ulker 
Fidan. 

A trip is planned to Rio de Janeiro, 
leaving Montreal April 6 and returning 
April 19. Enquiries should be direc- 
ted to club headquarters at 42 1 3 Place 
Ostell, Montreal 308, Quebec. — 
Isabelle Adams, president, Nurses' 
Social Club, Montreal. 

Comment on results of research 

Willett et al are to be commended 
for their study "Selection and success 
of students in a hospital school of nurs- 
ing" (January 1971, p.41). For the 
sake of students, the profession, and 
society as a whole, it is important to 
improve the selection of applicants 
and thereby minimize attrition from 
nursing educational programs and 
later attrition from the profession. 
The authors' findings about the use 
of specific tests for predictive purposes 
in selecting students likely to achieve 
success in basic nursing programs should 
be helpful to educators in nursing and 
other fields. 

I would be interested in further 
discussion of the characteristics of the 
"dropouts." Although the authors 
report differences in the College Qual- 
ification Tests (CQT) percentiles for 
the group of persisting students 
("class") and the group of "dropouts," 
they also indicate that statistically 
significant correlations were established 
between less than half the CQT Total 



Scores and in-course marks in the three 
class years, 1967, 1968, and 1969 
(D.44). 

On the same page, the authors des- 
cribe the "dropouts" as differing from 
the class in a measurement entitled 
"reserve," that is, the "dropouts" are 
characterized as being "much more 
outgoing, warmhearted, easygoing 
and participating." The authors consid- 
er these to be desirable characteristics, 
but conclude that the student who may 
be occupied with fulfilling these aspects 
of her personality may spend less time 
than required on her studies. 

The data reported above regarding 
differences between groups on CQT 
percentiles and correlations between 
CQT Total Scores and in-course marks 
are insufficient to provide support for 
this conclusion. In the absence of sup- 
porting data, one wonders if an equally 
valid conclusion might be that a number 
of the "dropouts" may have withdrawn 
because they viewed the program as 



Letters Welcome 

Letters to the editor are welcome. Be- 
cause of space limitation, writers are 
asked to restrict their letters to a 
maximum of 350 words. 



MOVING? 
BEING MARRIED? 

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otherwise you will likely miss copies. 



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OR 

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OTTAWA 4, Canada 



4 THE CANADIAN NURSE 



being rather rigid and restricting, with 
limited opportunities for their own 
self-fulfillment and satisfaction. 

In considering attrition, should we 
not examine the image of nursing held 
by in-course students and "dropouts" 
as well as assessing the usefiilness of 
screening tests administered prior to 
admission? — Dorothy J. Kergin, 
Reg.N., Ph.D., Professor of Nursing, 
McMaster University, Hamilton, Ont. 

Curricula should be standardized 

Now that two-year programs for nurs- 
ing education are being phased in and 
national nurse registration examinations 
developed, is it not time for educators 
to develop a standard content for curric- 
ula? 

At present, each nursing school has 
to analyze and interpret the broad 
guidelines that are provided in the 
province. This means that nursing 
education differs considerably, even 
in schools in the same province, and 
nurse educators spend many hours 
determining the content of their pro- 
gram. Many I have spoken to believe 
they attend far too many meetings, 
which interfere with work assignments. 
One asked quizzically, "Are we teach- 
ers, or are we meeters?" If some of these 
meetings could be eliminated, time 
would be available for other duties. 

How much easier it would be it mere 
were a standard curriculum content, 
devised by nurse educators through- 
out Canada in cooperation with nurs- 
ing schools. Individual schools would 
then have to decide only on the type 
of curriculum that is best for them, 
and where, when, and how, to fit in 
the specified content. The teachers 
would then devise methods of present- 
ing the content in their own way. 

This would still allow each school 
sufficient flexibility and opportunity 
for creativity, based on its own philoso- 
phy. It would also allow more time 
for guidance and evaluation of students. 
This latter area has often been neglect- 
ed because of the amount of time need- 
ed for accurate, consistent evaluation. 

If content were standardized, re- 
searchers would have an opportunity 
to devise or locate tests of achievement 
for motor, intellectual, or psycho-so- 
cial skills. This, in turn, would help 
make the process of evaluation more 
objective and the guidance of the stu- 
dent more realistic. — Gladys Jones. 
Reg.N., B.Sc.N.Ed., Ottawa. ^ 

MARCH 1971 



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SUPERVISOr ^ 



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Fine selection of dainty, jewelry-quality Cap 
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No. CT-1 Initial Tacs 

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No. 3502 Chrome Finish 8.00 ea. 

No. 6602 12 Kt Gold Filled... llJSOea. 




Nurses' White CAP CLIPS 

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bobbie pins, enamel on fine spring steel. Eight 

2' and eight 3' clips included in plastic snap 

bo». 

No. 529 ( 3 boxes for 1.75, 6 for 3-25, 

Clips S 7 or more 49c per box, all ppd. 



Bzzz MEMO-TIMER 

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sets to buzz at from 5 to 60 minutes. White 
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attached, Swiss made. 
No. M-22 Timer . . . 3.98 ea. ppd. 
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Deluxe POCKET-SAVER 

No more tired pockets! Sturdy pure wtiite vinyl, 
with three compartments for pens, scissors. 
etc, includes change pocket with snap closure 
for coffee money, and key chain. 4" wide. 

No. 791 (6 for 2.98, 12 for 430, 

PocKet Saver \ 25 or more 35c ea., all ppd. 



NIGHTINGALE LAMP 

An authentic, unique favor, gift or en- 
graved award! Ceramic off-white can. 
dieholder with genuine gold leaf trim. 
Recessed candle cup at front (candle 
not included) 7" long. 
No. F lOOS Lamp . . . 5.95 ea. ppd. 
SPECIAL! 12 or more, 3,95 ea. 
ENGRAVING up to 3 initials and 
date on satin gold plaque on top, add 1.00 per lamp. 





Trl-Color BALL PEN 

Write in black, red and blue with one ball point pen. 

Flip of the thumb changes point (and color) Steno fine 

point (excellent for charts). Polished chrome finish, 

Ni.921 Ball Pen,., 1. 50 ea. ppd. 

SPECIAL! 3 for 3.75, 6 or more 1 ,00 ea. ppd. 

No. 292-lt 3-color Refills . . . SOc ea. ppd. 



Caduceus CUFF LINKS 

Sim. Mother-of-Peari set into gold finish link, 
spring arm Sculptured gold fin, caduceus with 
or Without RN Gift-twxed. 

No. 403900 LINKS (plain caduceus)/ 3.95 pr. 
No. 403RN LINKS (R.N. Caduceus) { ppd. 




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sterling HORSESHOE KEY RING 

Clever, unusual design: one knob unscrews for in- 
serting keys. Fine sterling stiver throughout, with 
sterling sculptured caduceus charm. 
No. 96 Key Ring 3.75 ea. ppd. 



EYEGLASS CADDY Pin 

Si<p eyeglass bow into loop for safe, instant 
readiness . - . avoid scratching, breakage Sturdy 
pinback. safety catch. Gold or Silver plated. 
No. Ml Caddy... 1. 50 ea. ppd. 
No. 96T ST Starlini Sllvir Caddy ... 3.00 ea. ppd. 




NURSES CAP-TAGS 

Remove and refasten cap band instantly 
for laundering and replacement! Tiny .. 
molded plastic tac. dainty caduceus. *. 
Choose Black, Blue. White or Crystal '. ' 
with Gold Caduceus, or all black (plain) ^^ 
No.200Setof6Tac5.. 1.00 per set 
SPEC lAL ! 12 or more sets ... .80 per set 




Nurses ENAMELED PINS 

Beautifully sculptured status insignia; 2-colQr keyed. 
hard-fired enamel on gold plate. Dime-sized; pin-back. 
Specify RN. LPN, PN. LVN. NA. or RPh. on coupon. 
No. 205 Enameled Pin 1JK> ea. ppd. 



Sel-Fix NURSE CAP BAND 

Black velvet band material. Self-ad- 
hesiVe presses on. pulls off; no sewing 
or pinning. Reusable several times 
Each band 20" long, pre-cut to pop- 
ular widths; Vi' (12 per plastic box). 
^' (8 per box). *4" (6 per box). 1" 
(6 per box). Specify width desired in 
ITEM column on coupon 




No. 6343 

Cap Band... l box 1.50 
3 or more 1.25 ea. 



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Lend protessjonal prestige Two colors baked enamel on 
gold background Resists weather Fused Stud and 

•y Adapter provided Specify letters desired RN, MD. 00. 

/ RPh. DDS. DM0 or Hosp. StaH (Plain! 

No. 210 Auto Medallion 5.00 ea. ppd. 



Professional AUTO DECALS 

Your professional insignia on window decal 
Tastefully designed m 4 colors. 4Vi" dia. Easy 
to apply. Choose RN, LVN, LPN or Hosp. Staff 
No. 621 Decal... 1.00 ea.. 

3 for 2.50, 6 or more .60 ea. 





Uniform POCKET PALS 

Protects against stains and wear. Pliable white 
plastic with gold stamped caduceus. Two com- 
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No. 210-E ( 6 for 1.50, 10 for 2.25 
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RN/Caduceus PIN GUARD 

Dainty caduceus fine-chained to your professional 
letters, each with pinback. saf. catch. Wear as is 
, . or replace either with your Class Pm for safety 
Gold fin., gift-boxed. Specify RN, LVN or LPN. 
No. 3240 Pin Guard 2.95 ppd 




Personalized EXAMINING PENLIGHT 



Deluxe model designed for Nurses, with caduceus 
imprinted on white barrel; aluminum band and 
pocket clip. FREE initials hand-etched on band to 
prevent loss. 5" long. U.S. made. Batteries, bulb 
included (replacements any store). Plastic gift box 
No. 007 Penljght 3.98 ea. ppd. 







NURSES CHARMS 

Finest sculptured fisher charms in Sterling or 
Gold Filled. Ideal addition for bracelet or hang 
on pendant cham. 

Choose No. 263 Caduceus, No. 164 Nurses 
Cap, No. 68 Graduation Hat or No. 8 Band- 
age Shears 2.75 ea. ppd. 

Specify Sterling or G.F. under COLOR en coupon. 




"Endura" Waterproof NURSES WATCH 

Swiss made, raised silver full numerals, lumin mark- 
ings Red tipped sweep second hand, chrome stainless 
case Includes genuine black leather watch strap. 1 
year guarantee 

No. 1093 14.95 ea. ppd. 



Scripto PILL LIGHTER 

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gifts for friends. Guaranteed by Scripto. 
No. 300-P Pill Ligttter 4.28 ea. ppd. 



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25-99 pins. 5%; 100 or more, 10%. 

Send cash, m.o., or check. No billings of COD'S. 



Nurses' Personalized 

ANEROID 
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A superb scientific instrument espe 
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Easy-to-attach Velcro cuff, light- 
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leather zipper ed case, only 
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your own instrument and case forever. 
No. 106 Sphyg. . . 26.95 ppd. 6 or more . . . 22.95 ea. ppd. 





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Famous Littmann nurse's dia- 
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blood pressures, general auscu- 
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Full 28' vinyl anti-collapse tub- ' 
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diaphragm Non-fotatmg. correct- ' 
ly-angted ear tubes U S made ' 
Choose from 5 jewel-like colors: 
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news 



National Conference Called 
On Assistance To Physicians 

Ottawa — A three-day national con- 
ference on assistance to physicians will 
take place in Ottawa April 6-8. Partici- 
pants in the conference will attempt to 
determine the need for specially trained 
personnel to help physicians meet in- 
creasing demands for health care serv- 
ices and the complementary roles and 
responsibilities of the medical and 
nursing professions in meeting the 
need. 

Physicians, nurses, government plan- 
ners, consumers, researchers, and 
spokesmen for other sectors of the 
health field will attend the conference. 
Jointly planning the conference are the 
department of national health and wel- 
fare, the Canadian Medical Associa- 
tion, L'Association des medecins de 
langue frangaise du Canada, the Cana- 
dian Nurses' Association, and the Con- 
sumers Association of Canada. 

It will be a working conference with 
small groups attacking each problem 
area after examination of background 
papers. The agenda and speakers are 
yet to be announced. The conference 
will be held at the government confer- 
ence center. 

Recommendations resulting from 
the conference will be available to all 
interested agencies and will be presented 
at the national conference on education 
of health manpower to be held in Otta- 
wa later in 1971. 

One resolution passed at the Cana- 
dian Nurses' Association's June gen- 
eral meeting in Fredericton directed 
CNA to request the department of 
national health and welfare call a na- 
tional conference, prior to the spring 
of 1971, to provide a forum for discus- 
sion among "the major purveyors (nurs- 
ing and medicine) and consumers of 
health services" on more effective uti- 
lization of medical manpower with 
special emphasis on the development 
of complementary roles for nurses and 
physicians. 



Two CNA Standing Committees Meet 

Ottawa — The standing committee on 
nursing education and the standing 
committee on nursing service met at 
CNA House January 20-22. Both 
having many new members, they met 
jointly the first morning for orientation. 
As their separate sessions progressed, 
MARCH 1971 



Australian Educator on Study Tour 





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Moira B. (Topsy) Moffett discussed the two categories of nurse — university 
and diloma school graduate — with Dr. Helen K. Mussallem during her visit 
to CNA House, Ottawa, on January 22. 

Miss Moffett, who is responsible for the nursing administration diploma course 
at the Queensland branch of the College of Nursing, Brisbane. Australia, is 
currently on a Winston Churchill traveling fellowship using nine weeks of her 
summer vacation to visit the United States, Great Britain, Sweden, and Finland 
following her stay in Canada. Her Canadian tour has included visits to the 
University Hospital in Saskatoon, The Hospital for Sick Children and the 
Quo Vadis School of Nursing in Toronto, Ontario. 



members found their interests and 
functions overlapped considerably. 

Staff development and continuing 
education figured largely in discussions 
at both meetings, as did a position 
paper on staff education or develop- 
ment, and job description. 

The committees considered amalga- 
mation into one committee, meeting 
more frequently than in the past. They 
wanted to improve communications 
both from and to the "grass roots," 
to have information exchanged on a 
continuing basis. 

Most urgently, they wanted an "arm- 
chair," or "thinkers" conference of 
not more than 10 nursing leaders to 
plot the course of nursing for the seven- 
ties. They wanted this soon, so a report 



could be ready by the end of May. 

The above are but a few of the ideas 
to be presented to the board of the 
Canadian Nurses" Association at their 
next meeting. 

Irene Buchan is chairman of the 
nursing service committee, with prov- 
inces represented as follows: Alberta, 
Gertrude Clarke; British Columbia, 
Joan Dawes; Manitoba, Jacqueline 
Robertson; New Brunswick, Sister 
Mary Loretta Gaffney; Newfoundland, 
Alice Finn; Ontario, Norma A. Wylie; 
Prince Edward Island, Sonia Griffin; 
Quebec, Carmen Gauthier and Eileen 
Strike; Saskatchewan, E. Jean Belfry. 
Gladys Smith of Nova Scotia was ab- 
sent. 

Alice J. Baumgart is chairman of 

THE CANADIAN NURSE 7 




the nursing education committee, with 
provinces represented as follows: Al- 
berta, Gloria Bauer; British Columbia, 
Elizabeth Moore; Manitoba, Sally 
Joy WinkJer; New Brunswick, Sister 
Huberte Richard; Newfoundland, Leila 
Caruk; Nova Scotia, Sister Joan Carr; 
Quebec, Denise Lalancette and Mona 
E. Callin; Saskatchewan, Catherine 
O'Shaughnessy. Amy Griffin of Ontario 
and Margaret Newson of Prince Ed- 
ward Island were unable to attend. 

Large Number Of Candidates 
Write CNATS Examinations 

Ottawa — Over 6,000 candidates wrote 
the first national tests to be conducted 
by the Canadian Nurses' Association 
Testing Service (CNATS) in August 
1970. A total of 28,085 papers were 
written in the five subject areas. 

The results of the examinations, sent 
to candidates in November, were based 
on the same scoring system as that used 
by the National League for Nursing in 
the United States, that is, transformed 
scores based on a mean of 500, with 
a standard deviation of 100. 

Eight provincial registering bodies 
used 325 as their passing score; the two 
remaining provinces, Quebec and 
Newfoundland, used 350. The CNATS 
board hopes that agreement will even- 
tually be reached on a common passing 
score for all provinces. 

Translations of the tests were pro- 
vided for French-speaking candidates 
in Ontario and New Brunswick. French- 
speaking candidates in Quebec do not 
use the national tests. 

CNATS, which set up its operation 
in Ottawa May 1, 1970, is also under- 
taking to provide a test for nursing as- 
sistant registration. 

Nurse Educators Travel 
To North On Seminars 

Edmonton, Aha. — Three seminars 
in January, February and March, spon- 
sored by the medical services branch of 
the department of health and welfare, 
had nurse educators traveling north to 
observe the department's programs for 
health care. 

The 1 1 members of the first northern 
travel seminar who left on January 20 
for Inuvik were: Barbara Campbell, 
school of nursing. University of Wind- 
sor, Windsor, Ont.; M. Dumont, school 
of nursing. University of Moncton, 
Moncton, N.B.; M. Kutsche, school of 
nursing, McMaster University, Hamil- 
ton, Ont.; June Horrocks, school of 
nursing. University of British Colum- 
bia, Vancouver, B.C.; Mary McCulley, 
8 THE CANADIAN NURSE 



Enthusiasm Evident As Committee Begins Work 

OMOWMJtW 




The first meeting of the Canadian Nurses" Association ad hoc committee on 
French-language texts was held at CNA House February 1-2. The committee 
was set up by the CNA board in October, 1 970, to develop and encourage the 
publication and translation of French-language nursing textbooks. Committee 
members are, left to right, Claire Sauve of the CEGEP College Bois de Boulor 
gne, Montreal, Quebec; Marcella Dumont, Moncton University school of nurs- 
ing, Moncton, New Brunswick; Marie-des-Anges Loyer, University of Ottawa, 
Ottawa; chairman Huguette Labelle, CNA second vice-president; Claire Bigue, 
editor, L'infirmiere canadienne; Margaret Parkin, CNA librarian; Therese 
d'Aoust, education consultant. Association of Nurses of the Province of Quebec; 
Noella Gervais, University of Montreal, Montreal; Professor Nicole David, 
Laval University school of nursing, Quebec City. The committee will meet 
again on March 26 at CNA House m Ottawa. 



school of nursing. University of Toron- 
to, Toronto, Ont.; Joan Mills, school of 
nursing, St. Francis Xavier University, 
Antigonish, N.S.; CNA president, E. 
Louise Miner, Saskatchewan depart- 
ment of public health, Regina, Sask.; 
Mary Peever, school of nursing. Uni- 
versity of Calgary, Calgary, Alta.; M. 
Ross, school of nursing. Mount Saint 
Vincent University, Halifax, N.S.; Dr. 
Lucy D. Willis, director, school of 
nursing. University of Saskatchewan, 
Saskatoon, Sask.; June Agnew, school 
of nursing, Memorial University, St. 
John's, Nfld. 

The first seminar began with a two- 
day briefing session at the northern 
region office of medical services in 
Edmonton. After a one-day orientation 
session at Inuvik, the educators were 
flown to isolated nursing stations to 
participate in nursing activities. 

They undertook such assignments as 
conducting a medical clinic, assessment 
of a patient's condition and admission 
to the nursing station, and planning 
with a community health worker. They 
also met with local health committees 
or with the community chief and coun- 
cillors. The field experience will enable 
the nurse educators to interpret to their 



students the needs of northern Cana- 
dians and perhaps to expand nursing 
education to meet those needs. 

The second travel seminar originated 
from Montreal in February and the 
third leaves from Winnipeg this month. 
Representing CNA on the second sem- 
inar was first vice-president Kathleen 
G. DeMarsh. Helen Taylor, president 
of the Association of Nurses of the 
Province of Quebec, will represent 
CNA on the third seminar. 

Fellowships, Research Projects 
Funded By National Health Grant 

Ottawa — The $2,100,000 National 
Health Grant has funds available to 
nurses interested in research, said 
Pamela Poole when explaining the re- 
finements of the federal government 
grant to staff at CNA House January 
27. Miss Poole is nursing consultant 
for the hospital services study unit, 
health insurance and resources branch 
of the department of national health 
and welfare. 

The grant is designed to support 
health-care research projects, demon- 
stration models, special service/edu- 
cational programs, and personnel (na- 
(Conliniied on page 10) 
MARCH 1971 



BOOKS FOR PROFESSIONAL GROWTH 



1, 



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edited by Kay Carman Kintzel, R.N., M.S.N. With 20 Contributors 

This is the first text designed to foster expertise in the more complex 
as well OS little-explored aspects of clinical nursing. Sixteen areas 
requiring sophisticated nursing intervention are presented in in- 
depth studies. Each subject includes: the mechanism producing the 
health problem; manifestation ond course of the problem in relotion 



to the producing mechanism; data fundomenfal in assessing patients' 
needs and formulating nursing goals; appropriate nursing inter- 
vention. Emphasis is on prevention, continuity of care, the nurse's 
role in relation to the patient's family and the community, and the 
nurses' responsability in patient teaching and rehabilitation. 



500 Pages 



100 lllustrotiom 



April 1971 



$13.50 



2. New (5frh) Edition SIGNS AND SYMPTOMS: *"-"•*' •""•"'''•«'' '""^'"'-'^ 



Edited by Cyril Mitchell MacBryde, M.D., F.A.C.P., 

Associate Editor, Robert Stanley Blacklow, M.D. With 39 Contributors 

Extensively revised and expanded in the light of current knowledge, 
this text approaches diagnosis through the analysis and inter- 
pretation of presenting signs and symptoms. Each chapter presents 
a major symptom or sign, clarifies the mechanism of its production, 

1025 Pages 



and Clinical Interpretation 



and describes its correlation with other symptoms ond with physical 
ond laboratory findings. Exceptionally helpful to nurse clinicians 
in assessing patient problems, and a valuable guide in teaching 
students to develop the skills of observation. 



241 Illustrations, 4 Color Plates 



5th Edition, 1970 



$23.75 



3. New (4th) Edition SURGERY: Principle, and Praeti.. 

By Jonathan E. Rhoads, M.D., D.Sc. (Med.); J. Garrott Allen, M.D.; Carl A: Mayer, M.D.; 
and Henry Harkins, M.D., Ph.D. With 39 Contributors 



Revised and updated to reflect the most modern concepts of 
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Virtually all surgical disciplines ore covered including such important 
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related problems, tissue and organ transplontotion, pre- and post- 
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1864 Pages 



758 Illustrations 



4th Edition, 1970 



$25.00 



4 New CLINICAL GERIATRICS 

Edited by Isadore Rossman, M.D., Ph.D. With 29 Contributors 

The geriatric patient is exomirfeot in totality by a cross-disciplinary 
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512 Pages 



170 Illustrations 



March, 1971 



$25.00 



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D SIGNS AND SMPTOMS, 5lh Edition $23.75 

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MARCH 1971 



THE CANADIAN NURSE 




(Continued from page 8) 

tional health research scientists, na- 
tional health fellows, and visiting 
scientists). 

"Canada needs people highly quali- 
fied in research methodology, and these 
include nurses," Miss Poole said. 

Research training fellowships should 
be of particular interest to nurses. 
Although generally offered to persons 
under 35 years of age, there are a limit- 



ed number of senior fellowships avail- 
able to older candidates who wish to 
obtain training in health-care research, 
and who have demonstrated ability 
and practical experience in one of the 
health professions or a discipline 
relevant to health care research. 

Miss Poole said that if nurses in- 
terested in research would write to her 
at Ottawa, she could, in the course of 
her travels, talk to groups regarding 
the National Health Grant. 

The department of national health 
and welfare, entrusted with the ad- 
ministration of this fund, has appoint- 
ed a review committee of which Miss 
Poole is a member. This committee 




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10 THE CANADIAN NURSE 



meets three times a year — in Febru- 
ary, June, and October. Although 
applications are made directly to the 
department, processing them does take 
time she said. To be considered at the 
research committee's next meeting 
in June, an application should reach 
the department by May 1 . 

Prospective grantees may request 
a National Health Grant prospectus 
and application forms by writing to 
the Health Grants Directorate, Depart- 
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Migrant Nurses To Attend 
French-Language Classes 

Montreal, Que. — Bill 64, the con- 
troversial language legislation enacted 
by the government of Premier Robert 
Bourassa, means that professionals 
immigrating into the province will have 
to acquire a working knowledge of 
French (and a certificate to prove it) 
before they can join their professional 
associations. 

Without French, newcomers, who 
are not Canadian citizens, will be barred 
from the College of Physicians and 
Surgeons, the Association of Nurses of 
the Province of Quebec, the College of 
Pharmacists, and 1 6 other professional 
groups. 

Cecile Gauvin, ANPQ assistant 
secretary-registrar, said the association 
is pleased with the new law. She ex- 
plained that language classes, funded 
by the federal government and admin- 
istered by the provincial government, 
are available to immigrants. The ANPQ 
provides information about the classes 
to nurses arriving from other countries. 

Classes run for 35 weeks. The lan- 
guage student takes a basic course in 
elementary French for 20 weeks and 
receives a weekly stipend. The last 15 
weeks of the course are given as an 
extension of the basic course and the 
student receives no stipend. However 
the immigrants must successfully com- 
plete this part of the course to receive 
the language certification necessary 
for them to enter the 19 listed profes- 
sions. 

Although the course is free, Miss 
Gauvin thought the immigrants would 
likely have to find another job for the 
almost four months of the last part of 
the course. She did not suggest what 
kind of temporary work they might 
find, but said they would not be eli- 
gible for employment as auxiliary 
nurses. She added that if there were 
problems the immigration branch would 
provide assistance. 

Miss Gauvin pointed out a loophole 
in the law. The law states the immi- 
grant must acquire a working knowl- 
(Continued on page 12) 
MARCH 1971 



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{Continued from page 10) 

edge of French as a requirement of 
accreditation from the professional 
associations, but nothing is said about 
the language used in actual practice. 
"So we feel legislation such as Bill 64 
is just a start," said Miss Gauvin. 

To make the law more attractive to 
the immigrant, the provincial gov- 
ernment has abolished the requirement 



of Canadian citizenship to join the 
professional associations. The immi- 
grant will only have to undertake to 
apply for citizenship "as soon as he 
may do so under the Canadian Citizen- 
ship Act." 



Manitoba Nurses Now 
Accept Bargaining Concept 

Winnipeg, Man. — The province's 
nurses are gradually accepting the con- 
cept of collective bargaining, but it's 
been a slow process, according to Glen 
Smale, chairman of the provincial staff 
nurses' council established by the Man- 




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^5mC^ Dept.C-2 




12 THE CANADIAN NURSE 



itoba Association of Registered Nurses 
at its May 1970 annual meeting. 

The new council's objective is to 
overcome misconceptions nurses have 
about collective bargaining. The council 
is making available information, ad- 
vice, and facilities to assist nurses form- 
ing bargaining units and conducting 
collective bargaining. 

The council executive includes Jean 
Burrows of St. Boniface Gejieral Hos- 
pital, vice-chairman; Patricia Rathwell 
of Brandon General Hospital, secretary; 
and Greer Black of Red River Com- 
munity College, treasurer. 

"Nurses have had paternalism pxjund- 
ed into them since the day of Florence 
Nightingale," said Mr. Smale in a 
Winnipeg Free Press interview. "We 
don't pressure collective bargaining. 
It has to start from within a hospital." 

Mr. Smale, who is working to develop 
regional collective bargaining units for 
registered nurses, said support for staff 
associations increases as nurses realize 
they can have a say in improvements in 
the services provided by their hospital. 

Within the past three years staff 
associations were formed by registered 
nurses working in the St. Boniface, 
Misericordia, and Victoria general 
hospitals in greater Winnipeg; in the 
Brandon and Assiniboine general hos- 
pitals in the Brandon area; and the 
Winnipeg Civic Registered Nurses' 
Association. 

These seven associations recently 
formed a negotiating committee to 
consist of a representative from each 
association to bargain on behalf of 
members on a regional basis. 

Nova Scotia Nurses 
Sign 1971 Contracts 

Halifax, N.S. — Contract negotiations 
for 1971 are well underway for Nova 
Scotia nurses. Eight staff associations 
have completed agreements. Two staff 
associations, the Aberdeen Hospital, 
New Glasgow, and the Colchester 
Hospital, Truro, are in conciliation 
and the staff association, Payzant Me- 
morial Hospital, Windsor, is negotiating 
a contract. 

At Dawson Memorial Hospital, 
Bridgewater, the Registered Nurses 
Association of Nova Scotia and the 
hospital board signed an agreement in 
January for a twenty-month contract 
terminating on December 31, 1971. 

Kay Buckler, president of the staff 
association, said the agreement provides 
a means of improving communications, 
working conditions, and salaries. A 
professional practice committee was 
formed to deal with developments and 
difficulties related to nursing. The 
agreement provided a salary increase at 
the general staff level of $50 per month 
from May to December 1970, plus a 

MARCH 1971 



bonus of $200; a further increase of 
$25 is scheduled for 1971, raising the 
monthly salary to $500. 

Nurses' staff associations in five 
Cape Breton hospitals: St. Elizabeth 
Hospital, North Sydney; St. Joseph's 
Hospital, Glace Bay; New Waterford 
Consolidated Hospital, New Waterford; 
St. Rita Hospital and Sydney City 
Hospital, Sydney, signed their first 
collective agreements with their hospital 
boards in January. 

The agreement, in effect for 1971, 
provides for a sum of $600 to be paid to 
each nurse for 1 970 and a new starting 
salary of $500 per month, a raise of $25 
per month. The contract, similar for all 
five hospitals, emphasized provision 
for improved communication between 
nurses and hospital officials to deal 
with problems outside the collective 
agreement, as well as the usual griev- 
ance and arbitration procedures. 

Negotiations began locally but it was 
necessary to proceed to conciliation. 
During this time the presidents of the 
staff associations, Eleanor MacNeil of 
New Waterford, Beverly O'Neil of 
North Sydnev, Mabel Latham of Sydney 
City, Olive MacKinnon of St. Rita's and 
Esther Turner of St. Joseph's, met on a 
joint basis. At negotiating sessions, 
M argaret Bentley of Hal ifax represented 
the staff associations and Freeman 
Jenkins of Glace Bay the involved 
hospital boards. 

AARN Brief Presented 
To Premier And Cabinet 

Edmonton, Aha. — The tightening of 
the job market and the shortage of 
nurses for leadership positions were 
two issues the Alberta Association of 
Registered Nurses discussed with Pre- 
mier Harry Strom and members of 
his Cabinet in the January presentation 
of the association's annual brief. 

Noting that the supply of practicing 
nurses in the province mcreases each 
year, AARN statistics show an increase 
of 7.1 percent in total active practicing 
memberships, compared to an increase 
of 5.5 percent last year. 

The brief states, "Three to four years 
ago while health services were expand- 
ing rapidly there was a severe shortage 
of nurses in Alberta, however, this 
situation no longer exists." 

The AARN surveyed the schools of 
nursing in October since there were 
worries about unemployment of nurses 
especially in graduating classes. The 
survey revealed that of total graduates 
— 616 from diploma schools of nurs- 
ing and 234 from the University of 
Alberta — not more than 36 nurses, 
seeking employment, were unemployed. 

"Nursing positions have been diffi- 
cult to locate in the larger cities, partic- 
ularly in Calgary," said the brief, 
but there continues to be vacancies 

MARCH 1971 



m rural areas and m the Federal Health 
Services." 

The problems of directors of nurs- 
ing, especially in rural hospitals, is a 
matter of "grave concern" to AARN. 
"There is a dearth of nurses prepared 
for leadership positions in nursing 
service in Alberta and in all provinces 
of Canada. Positions of nursing admin- 
istrative resjxjnsibility are still being 
filled with persons having no further 
preparation than their basic program. 

"Although many hospital boards 
recognize the importance of a well- 
prepared director of nursing, and ad- 
vertise in this manner, they too fre- 
quently have no alternative but to 
appoint a less prepared nurse who also 
recognizes the inadequacy of her prep- 
aration. There is no pool of prepared 
nurses from which to draw." 

Some AARN recommendations to 
alleviate the problem are: 1 . minimum 
qualifications for a director of nursing 
and administrator be established; 2. 
the goal of adequate preparation be 
facilitated by incentives in the form of 
bursaries and sabbatical leave; 3. reg- 
istered nurses with a baccalaureate 
degree be encouraged to seek experience 
and preparation in management tech- 
niques; 4. in the interim, crash pro- 
grams in the form of seminars or work- 
shops be made available immediately 
to directors of nursing. 

To get the "crash program" under- 
way, the AARN is providing financial 
assistance for a series of workshops as 
a beginning step in supplementing the 
knowledge of present directors of nurs- 
ing. A spring workshop is planned 
using the resources of the department 
of health service administration. 

The brief also noted that the AARN 
is a member of the Coordinating Coun- 
cil on Nursing established on a vol- 
untary basis during 1970 by five nurs- 
irig groups. 

Task Force Discussion 
By Quebec Chapter 

Quebec City, Quebec — The Quebec 
chapter of the Canadian Association 
of University Schools of Nursing is 
against the creation of a new category 
of health worker such as the physician's 
assistant. Members believe the role of 
nurses educated in university schools 
should be widened. 

Discussing the report of a provincial 
commission on health and welfare 
at a general meeting in January, mem- 
bers said the report, particularly the 
section on the role of the nurse clini- 
cian, should be clarified. They said 
the government and public do not seem 
to be aware of resources offered by 
nurses educated at the baccalaureate 
level. A brief will be presented by the 
association to the Minister of Health. 

The association, which includes 



professors from the McGill University 
school of graduate nurses, the Univer- 
sity of Montreal faculty of nursing, 
and the Laval University school of 
nursing sciences, was formed to de- 
velop and promote nursing university 
programs. Olive Goulet is president 
and Michele Charlebois, secretary- 
treasurer. 

RNANS Sponsors 
Three Courses 

Halifax, N.S. — The first continuing 
education program for the province's 
nurses, sponsored by the Registered 
Nurses' Association of Nova Scotia, 
was held at Mount Saint Vincent Uni- 
versity, Halifax. The course on the 
changing role of the nurse was given 
in eight night sessions beginning in 
November and finishing in January. 

Designed for head nurses, the course 
focused on the new managerial skills 
required by nurses, the altering role of 
the patient, and the legal responsibil- 
ities of the nurse. 

The RNANS program was to be'' 
repeated at Xavier College, Sydney, 
in February and at Mount Saint Vincent 
University in April. 

Ontario Government 
Proposes Change In Structure 
Of Health Disciplines 

Toronto, Ont. — A new and "greatly 
improved" structure for health dis- 
ciplines in Ontario was forecast by the 
provincial minister of health Thomas 
L. Wells at a press conference held 
January 25. The proposals to update 
and revise procedures of regulation 
and education in the health disciplines 
stem from recommendations in the 
Report of the Committee on the Heal- 
ing Arts. 

Mr. Wells said the proposals he was 
presenting would serve as a basis for 
discussion with the various health pro- 
fessions and lead to drafting new legisla- 
tion governing these professions. The 
major principles and recommendations 
are: 

1. The public interest should be the 
basic principle underlying the regu- 
lation of all the health disciplines. Since 
safe-guarding the public interest is a 
primary concern of the government, 
the government must assume responsi- 
bility for ensuring that satisfactory 
arrangements exist for the regulation 
of health disciplines. 

2. Self-regulatory procedures which 
have evolved within the health dis- 
ciplines should be preserved. The role 
of the public would be recognized by 
appointing a significant number of lay 
members to the regulatory bodies. 

THE CANADIAN NURSE 13 




3. The right of individuals to use the 
services of health practitioners of their 
choice should be respected. Any limi- 
tations on these rights should be design- 
ed specifically to protect the public 
interest. 

4. A health disciplines regulation board 
should be established by, and be respon- 
sible to, the minister of health for reg- 
ulation of all health disciplines. Existing 
colleges (of physicians, dentists, nurses, 



pharmacists, and optometrists) would 
be essentially self-regulatory, but res- 
ponsive to the requirements of the 
board. 

The board as seen by the minister 
would be composed of five or seven 
members of the general public who are 
not members of any health discipline. 
The board would be self-contained and 
not be part of the department of health. 
5. One of the functions of the board 
would be to act as an appeal board. 
Within their areas of responsibility, 
colleges and divisions would initially 
handle complaints from the public and 




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With the AmniHook the doctor does 
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14 THE CANADIAN NURSE 



health practitioners, but the board 
would hear appeals resulting from 
their decisions. 

6. Education of all health workers 
should be the responsibility of edu- 
cational rather than regulatory bodies. 
The education of health disciplines 
should be the responsibility of those 
bodies charged with the province's 
educational programs under the minis- 
ter of education. 

Mr. Wells also announced the form- 
ation of a workgroup with deputy min- 
ister of health. Dr. K.C. Charron, as 
chairman. This group will meet with 
the health discipline associations and 
complete discussions by March 15. 



AARN Brief Supports 
Status Of Women Report 

Edmonton, Aha. — In its annual brief, 
presented in January to Premier Harry 
Strom and his Cabinet, the Alberta 
Association of Registered Nurses drew 
attention to areas of specific interest 
to nurses in the report of the Royal 
Commission on the Status of Women 
in Canada. 

• Day-Care Centers: A single, most 
often requested item by Canadian 
women is for day-care centers accord- 
ing to the report. "Such a system would 
be of great value to the nursing profes- 
sion," said AARN. Day-care centers 
are seen as the "first step in a broader 
scheme of child care." 

• Salary Differentials: The commission 
has established that discriminatory 
practices involving salaries exist in 
many areas of female employment. 
"Nursing is no exception," said the 
AARN, endorsing the recommendation 
that "the concept of skill, effort, and 
responsibility be used as the objective 
factors in determining what is equal 
work; with the understanding that pay 
rates thus established will be subject 
to such factors as seniority provisions." 

• Taxation: The Association agrees 
with the Commission section on taxa- 
tion wherein joint tax returns options 
and child care allowances would be 
of great value to women. 

• Family Planning Clinics: Establish- 
ment in public health units is empha- 
sized by the Association to provide 
better health services to the public. 

• Maternity Leave: The AARN en- 
dorses the recommendation of adoption 
of provincial and territorial maternity 
legislation to provide for an employed 
woman's entitlement to 1 8 weeks mater- 
nity leave, mandatory maternity leave 
for the six-week period following her 
confinement unless she produces a 
medical certificate stating working 

(Continued on page 16) 
MARCH 1971 



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Fig. 6-3. Scheme to show how myosin interacts 
with actin to shorten muscle fibers. 



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Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. April, 1971. 8th edition, approx. 600 pages, 8" x 10", 
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(Continued from page 14) 

will not injure her health, and prohibi- 
tion of dismissal of an employee on 
any grounds during the maternity leave 
to which she is entitled. 

The AARN stressed the recommenda- 
tion that federal, provincial, territorial, 
and municipal governments each estab- 
lish a committee to plan for, coordi- 
nate, and expedite the implementation 
of the recommendations made by the 
Status of Women Commission and 
report to its government on progress 
made. 

Public Hospital Nurses 
Sign New Agreement 

Fredericton, N.B. — Nurses employed 
in New Brunswick's public hospitals 
signed their first collective agreement 
under the new Public Service Labour 
Relations Act on February 2. The 
21 -month agreement expires March 
31, 1972 and is retroactive to July 1, 
1970. 

The new contract covering 2,100 
nurses in public hospitals was signed 
by representatives of the provincial 
treasury board and the provincial 
collective bargaining council of the 
New Brunswick Association of Regis- 
tered Nurses. 

Salaries will increase 16 percent 
over the contract period. The schedule 
raises the basic salary for a registered 
nurse employed at the general staff 
level from $430 per month to $460 
per month, effective July I, 1970 to 
March 31, 1971. Effective April 1, 
1971 the beginning salary for a regis- 
tered nurse will be $500 per month. 
Four increments within the scale will 
place the general staff nurses at a max- 
imum of $580, effective April 1 . 

Increases in educational increments 
were granted for a masters or bacca- 
laureate degree, a one-year university 
course in nursing, a special six-month 
clinical preparation, and the nursing 
unit administration course. The contract 
also states that management recognizes 
the desirability of encouraging educa- 
tion and will grant leave of absence for 
such purposes. 

Among the other benefits is a re- 
duction in the hours of work from 40 
to 37-and-one-half hours per week. The 
article on retirement states that, follow- 
ing normal retirement at age 65, the 
nurse can return in a casual or part- 
time capacity. Pension plans not al- 
ready in existence will be established 
by March 31, 197 1 unless this deadline 
is extended by mutual agreement. 

Portability is another new benefit. 
If a nurse resigns from one hospital 
16 THE CANADIAN NURSE 



in the province and accepts a position 
in another New Brunswick hospital, 
she will take with her any unused sick- 
leave and vacation credits, providing 
that no more than 30 days elapse be- 
tween the resignation date and the date 
of the new position. 

The contract also provides for a 
professional practices committee to 
make recommendations for the im- 
provement and quality of patient care. 
Committee members will include the 
director of nursing and representatives 
from the staff association and hospital 
administration. 

Signing of the new agreement marks 
the conclusion of negotiations that 
began on August 1 1, 1970. 



NBARN Wants End 
Of Hospital Schools 

Fredericton, N.B. — The New Bruns- 
wick Association of Registered Nurses 
continues to urge the provincial govern- 
ment to phase out hospital schools of 
nursing and to establish nursing educa- 
tion at the diploma level in institutions 
similar to junior colleges. 

In a brief presented on January 22, 
to the provincial study committee on 
nursing education, NBARN recom- 
mended "that basic nursing education 
be placed within the educational system 
of the province in an institution whose 
primary purpose is education." NBARN 
states the present system of hospital 
schools is inadequate due to the con- 
flict created when an institution holds 
two objectives — service to the patient 
and education of nurses. 

"The primary purpose of a hospital 
is to provide service to the sick. All 
else within a hospital must take second 
place to this purpose, and this includes 
its school of nursing," said an NBARN 
release following presentation of the 
brief. 

Opposition to the phasing out of 
hospital schools has come from the 
New Brunswick Hospital Association. 
NBARN was criticized for holding too 
much power and authority in relation 
to nursing education and registration. 
The area of standard setting and reg- 
istration is under scrutiny by the com- 
mittee which is expected to submit its 
findings to the government in early 
June. 

Reiterating its respect for the integ- 
rity of present hospital schools, NBARN 
said the schools' deficiencies result 
from an "archaic system" which the 
schools cannot control. "The schools 
in hospitals have neither the educational 
facilities nor the level of qualified in- 
struction to prepare nurses to work 
effectively in the rapidly changing 
field of health. This is not the fault of 
the student, the school, or the hospital. 
The first call on available hospital 



funds is to provide facilities to care 
for the sick. Providing for education 
processes is a secondary purpose of the 
hospital, borne out in budgeting, pro- 
gramming, and staffing. 

"One example of the inefficiency of 
the present system is in the area of 
practical experience. The student in the 
hospital school receives practice by 
giving service to the hospital. This 
is borne out in hospital budgets where 
the student service is calculated at the 
rate of 30 percent for staffing pur- 
poses," said NBARN. 

"The student is working to meet 
service requirements of the hospital, 
not to meet the learning needs of the 
student. She is frequently required 
to work evening and night shifts al- 
though no instructor is available. This 
method of approach is haphazard and 
often irrelevant to the student's class- 
room program. 

"This present apprenticeship method 
of training nurses is no longer effective 
in educating nurses .... The change to 
ajunior college type of institution would 
combine the best features of the hospital 
programs with a more extensive educa- 
tion," said NBARN. 

The impossibility of staffing hos- 
pital schools with qualified instructors 
is also caused by the subordination of 
an education program to a service pro- 
gram, states NBARN. "Approximately 
61 percent of the instructors in these 
schools do not have the recommended 
requirement of a baccalaureate degree. 
The concentration of facilities and 
qualified instruction now spread among 
1 1 hospital schools into three or four 
junior college schools would alleviate 
this problem," said NBARN. 

Noting that the change from the 
apprentice-type training to an aca- 
demic-type training should be gradual, 
the NBARN brief recommended that, 
"the present hospital schools be phased 
into a limited number of independent 
diploma schools. That these be large 
enough to be economical and to be 
geographically placed so that optimum 
use IS made of the clinical, physical, 
and human resources for offering the 
program." 

Other recommendations in the brief 
were: 

• that the association continue to be 
the body to set, maintain, and upgrade 
as necessary, the standards for nursing 
education and practice. 

• that nursing assistant programs be 
phased out 

• that any registered nurse or registered 
nursing assistant who demonstrates 
ability have the privilege of further 
study .... that this upward mobility be 
so structured as to maintain standards 

• that all basic nursing programs con- 
tinue to be general nursing courses. 

MARCH 1971 



Nova Scotia Lacks 
Nurses With Degrees 

Halifax, N.S. — The province is be- 
low the national average in percentage 
of nurses holding degrees, according 
to a review committee report on Dal- 
housie University's School of Nursing. 

Only 2.8 percent of Nova Scotia's 
nurses hold a bachelor of nursing de- 
gree, compared with the Canadian 
average of six percent. 

Meanwhile the need for well-pre- 
pared health personnel increases as 
demands for better health care grow, 
said the report. The review committee 
recommends 135 bachelor of nursing 
graduates as a minimum objective for 
Nova Scotia. In May, 1970, the univer- 
sity graduated 38 students of nursing 

— seven were graduates of the new 
four-year program. 

■'The nurse with a degree is expect- 
ed to give leadership to nurses who 
provide bedside care. She is not an 
administrator, unless she has special- 
ized as such, although she is some- 
times precipitated into this role," said 
the report. 

"To improve nursing services, both 
institutional and community, a high 
proportion of nurses, about 25 percent 
of graduates, should have at least a 
baccalaureate," the committee advo- 
cated. 

Now in its twenty-first year, the 
Dalhousie nursing program offers a 
four-year basic degree program; a three- 
year degree program for registered 
nurses; a one-year diploma program 
for public health nurses and nursing 
service administration; and a unique 
two-year program leading to a diploma 
in outpost nursing. 

Dr. Helen Nahm, recently retired 
dean of the University of California 
School of Nursing, was visiting con- 
sultant. She suggested use of outpost 
nursing program experience in other 
health professions; establishment of 
a master's degree program in nursing; 
interim admission of qualified nurses 
to allied departments — M.A. or M.Sc. 

— and a program of continuing edu- 
cation for nurses. 

Dr. H.B.S. Cooke, of the univer- 
sity's faculty of arts and science, was 
committee chairman. Other committee 
members were: Dr. G. Ross Langley, 
faculty of medicine; Dr. Kenneth M. 
James, college of pharmacy; Dr. Edwin 
G. Belzer, school of physical education; 
and Dr. Robert M. MacDonald, dean 
of the faculty of health professions. § 



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17 



names 



"Fifty Yean A-Nursing" 




j To mark her 50th anniversary of graduation, fellow workers honored Jane 
Thomas at an informal gathering. In the photograph, Graham Edwards, a 
health inspector, presents a yellow rose corsage as Anne Beckwith, public 
health nurse, looks on. Florence Tomlinson, director of nursing, presented the 

, guest of honor with a purse from the staff. A native of Northern Ontario, Miss 
Thomas graduated from the School of Nursing, Toronto General Hospital, on 
June 6, 1920, and attended the first public health nursing course given at the 
University of Toronto, receiving her PHN diploma in June 1 92 1 . Miss Thomas 

j was the public health nurse in Sudbury schools for 39 years, and following 
retirement from the school board in 1959, joined the Sudbury Health Unit staff. 
She is highly respected and all who know her marvel at her proficiency and 
cheerfulness as she carries on the valuable nursing role of training and super- 
vising the registered nursing assistants as audiovisual technicians to give service 
in the Health Unit schools of the Chapleau, Gogama, Manitoulin, Espanola. 
Elliot Lake and Sudbury areas. 




Patricia S.B. Stan- 

ojevic(Reg.N., The 

Hospital for Sick 
Children School of 
Nursing, Toronto; 
B.Sc.N., U. of Brit- 
ish Columbia; M.Sc 
(App.), McGill U.) 
formerly assistant 
research and plan- 
ning officer (nursing) with the research 
and planning branch of the Ontario 
Department of Health, became director 
of the school of nursing, Toronto 
General Hospital, in January 1971. 
She succeeds Mary Horton, who re- 
signed for family reasons. 

Mrs. Stanojevic has had a wide range 
of experience in nursing endeavors. 
18 THE CANADIAN NURSE 



She has served as a general duty nurse 
and as a clinical instructor at the Hos- 
pital for Sick Children. She was also 
the first supervisor of inservice nursing 
education at that hospital. She has been 
an inspector of schools of nursing in 
Ontario; an assistant director of pro- 
fessional standards. College of Nurses 
of Ontario, and a lecturer, faculty of 
nursing, Queen's University Kingston. 

Constance A. Holleran (R.N., Massa- 
chusetts General Hospital School of 
Nursing, B.Sc, Teachers College, 
Columbia U.; M.Sc.N., Catholic U. 
of America, Washington, D.C.) was 
appointed director of the government 
relations department of the American 
Nurses' Association in January 1971. 



This department is located in Washing- 
ton, DC. 

Miss Holleran has been a faculty 
member at the Massachusetts General 
Hospital School of Nursing and taught 
at the Royal Victoria Hospital, Belfast, 
Northern Ireland. Prior to joining the 
ANA staff in 1970 as project coordina- 
tor, Miss Holleran had been for four 
years chief of the project grant section 
of the nurse education and training 
branch of the division of nursing, na- 
tional institutes of health, department 
of health, education and welfare. 



Mary Russell was named acting regis- 
trar of the New Brunswick Association 
of Registered Nurses, to replace Lois 
Gladney. Mrs. Gladney resigned for 
reasons of health, but continued on a 
part-time basis as consultant until the 
end of the year. 

I L o i s L. Gladney 

(R.N., Royal Victor- 
ia Hospital School 
of Nursing. Mont- 
real) retired for 
health reasons in 
December 1970 
I from her position 
as registrar of the 
New Brunswick 
Association of Registered Nurses. 

Joining the NBARN in 1957 as 
assistant to the secretary registrar, 
Mrs. Gladney became registrar two 
years later. In this time, the association 
membership has more than doubled, 
an indication of the registrar's respon- 
sibility. 

Mrs. Gladney was honored by friends 
and colleagues at the Lord Beaver- 
brook Hotel, January 18, when she was 
given a presentation in appreciation 
of her service to NBARN. 

This occasion also marked New 
Brunswick's premiere showing of The 
Leaf and the Lamp. 



ERRATUM 

Helena Reimer retired as secretary- 
registrar of the Association of Nurses 
of the Province of Quebec after 12 
years of service, not two, as was 
erroneously stated on page 1 9 of the 
Jai.uary 1 97 1 issue of the CNJ. 

MARCH 1971 






Joyce E. Gleason 

(R.N., Regina Gen- 
eral Hospital School 
of Nursing; B.Sc.N., 
U. of Saskatchewan) 
has been appointed 
employment rela- 
tions officer of the 
Manitoba Associa- 
tion of Registered 
Nurses to replace Laurel Rector, who 
has resigned for family reasons. 

Mrs. Gleason has worked in nurs- 
ing education and nursing service; has 
been responsible for nursing personnel, 
their welfare and development; and 
has kept in tune with the younger 
generation in schools of nursing. 

Sister Marie Simone 
Roach (R.N., St. 
Joseph's Hospital 
School of Nursing, 
Glace Bay. N.S.; 
B.Sc.N., St. Fran- 
cis Xavier U., An- 
tigonish,N.S.;M.Sc. 
Nursing Adminis- 
I tration, Boston U.; 
Ph.D., School of Education, Catholic 
U., Washington, D.C.) has been ap- 
pointed acting chairman of the nursing 
department of St. Francis Xavier Uni- 
versity, Antigonish. Prior to earning 
her Ph.D., Sister Roach was on the 
faculty of the Catherine Laboure School 
of Nursing in Boston. 

Beth (Bullis) Allan 

(Reg.N.. Toronto 
^^- /i Western Hospital 
-ffl^L. __iu School of Nursing; 
W'^iiwaj^ Dipl. Nursing Ad- 
* '^v. * min.,U. of Toronto) 
has been appointed 
coordinator of pa- 
tient relations at 
the York-Finch 
General Hospital, Downsview, Ontario. 
Through Mrs. Allan, the home care 
program of Metro Toronto is being of- 
fered to patients of this community 
hospital. She makes arrangements to 
enable patients to go home sooner than 
usual, assists in transferring patients 
to convalescent or chronic hospitals, 
and works with other community or- 
ganizations to obtain special help for 
patients who need it. 

Mrs. Allan's supervisory experience 
in many Toronto hospitals and her 
experience in organizing refresher 
and reorientation programs for reg- 
istered and public health nurses will 
be put to good use in her present chal- 
lenging position. 

Currently, she is studying toward 
a B.Sc.N. degree through the extension 
division of the University of Toronto, 
and is a director of the Rexdale unit 
of the Canadian Cancer Society. 
MARCH 1971 





IF YOU'RE HAVING 
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TRY THE IVOMETER 

Varying flow rates, bottles emptying too fast or too slow, 
infiltrations and stopped needles are common I.V. prob- 
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The I VOmeter, a disposable metered I.V. set has been 
shown to reduce the severity and frequency of these prob- 
lems. The nurse can now observe an indicator which 
shows, at a glance, the current flow rate compared to the 
deslTed flow rate. Because of the Stay-Set clamp the nurse 
can be assured that any change in flow is patient oriented. 

To find how IVOmeter's patented meter and clamping 
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THE CANADIAN NURSE 19 



Next Month 
in 

The 

Canadian 
Nurse 

• Basilar Aneurysms 

• Management of Parkinson's 
Disease with L-dopa therapy 

• The Subcutaneous Injection 



IL/KJ 



Photo credits for 
March 1971 



Crombie McNeill Photography, 
Ottawa, p. 7 

Studio Impact, Ottawa, p. 8 

The Sudbury Star, 
Sudbury, Ont., p. 18 

Hans I. Blohm, Ottawa, p. 20 

The University of Western 
Ontario, London, Ont., p. 32 

Roy Nichols Photographer, 
Willowdale, Ont., p. 41 

The Winnipeg General Hospital, 
Wmnipeg, Man., pp. 48, 49, 50 



names 




20 THE CANADIAN NURSE 



Ethel M. Gordon, R.N., was honored 
by the Professional Institute of the 
Public Service of Canada in Ottawa 
during celebrations marking its golden 
anniversary year. K.J. Harwood, pres- 
ident, presented her with an Institute 
Service Award in recognition of her 
outstanding service to the association 
and its 13,000 members. 

Miss Gordon, a member of the In- 
stitute since 1950, was cited for her 
valuable service to federally employ- 
ed nurses as chairman of their bar- 
gaining unit and to the Institute as a 
whole during her three-year term on 
its board of directors. 

Following retirement from the fed- 
eral public service in January 1969, 
Miss Gordon was appointed special 
consultant with the Institute in the 
field of health services groups. 

John V. Briscoe 

(R.N., Sefton Gen- 
eral H.; dipl, Brit- 
ish Orthopaedic As- , 
sociation) has been 
appointed assistant 
administrator (nurs- 
ing) and director of 
nursing services at 
Trenton Memorial 
Hospital, Trenton, Ontario. 

Before coming to Canada in 1961 
Mr. Briscoe was senior nursing officer- 
in-charge (Base Hospitals) in Iran with 
the Seven Year Plan for the Middle 
East (United Nations Organization). 

After holding a number of superviso- 
ry positions at Hamilton Civic Hospi- 
tals, Hamilton, Ontario, he accepted 
an appointment with Abbott Laborato- 





ries Limited in 1966. For the past two 
years Mr. Briscoe has been with the 
Royal Victoria Hospital, Montreal, 
first as manager of central supply, then 
as administrative assistant. Women's 
Pavilion and then as manager, oper- 
ating services. 

Betty Drury (R.N., Edmonton General 
Hospital School of Nursing: Dipl. in 
teaching and supervision, U. of Al- 
berta) was appointed director of nursing 
of the Sturgeon General Hospital, a 
new hospital near St. Albert, on the 
outskirts of Edmonton, Alberta. Miss 
Drury was previously on the staff of 
the Charles Camsell Hospital, Edmon- 
ton. Earlier, she had been clinical 
instructor, pediatrics, at the Edmonton 
General Hospital School of Nursing. 

T.M. Miller, public 
relations officer of 
the Manitoba Asso- 
ciation of Register- 
ed Nurses, was pres- 
ented with a life, 
membership in the 
Canadian Public Re- 
lations Society ear- 
ly in October. A 
founding member of the Manitoba 
branch of the society, Mr. Miller is a 
past president, and was awarded the 
Presidents Medal in 1965 for "'service 
to the Society, to public relations and 
to public welfare." 

Yolande Albert 

(R.N., Hotel Dieu 
Hospital School of 
Nursing, Edmuns- 
ton, N.B.), a former 
staff nurse at the 
Montreal Children's 
Hospital, has just 
begun another 10- 
month mission with 
the hospital ship Hope. 

On January 8, the hospital ship 
left Baltimore, Maryland, bound for 
Kingston, Jamaica, on a medical teach- 
ing mission in the West Indies with Miss 
Albert on board as one of its permanent 
specialized staff of 125. 

Miss Albert completed another 
"Hope" project in Tunisia a few months 
ago where she also participated in 
emergency relief activities undertaken 
by "Hope" during the devastating 
floods of 1969. Her role as nurse and 
teacher was featured in a documentary 
film. Doctor . . . Teacher . . . Friend. 

Further phases ot the project's cur- 
rent three-year hemispheric program 
will bring the S.S. Hope to Brazil in 
1972 and to Venezuela in 1973. Project 
"Hope" is the principal activity of the 
People-to-People Health Foundation, 
Incorporated, of Washington, D.C., 
an independent, nonprofit international 
health organization. 'te? 

MARCH 1971 




SCHERINB 



For effective relief 

of cold symptoms 

take the clear-headed 

family approach. 

Recommend Coricidin. 



Coricidin' is a whole family of cold fighters. Each form is 
formulated for maximum effectiveness in controlling 
cold symptoms. 

Coricidin 'D', for Instance, has five ingredients 
to combat every head cold symptom: a top-rated anti- 
histamine to stop running noses, two pain relievers and 
fever fighters, caffeine to brighten spirits and a decon- 
gestant to shrink swollen membranes. 

For the junior cold sufferer, Coricidin 'D' Medilets* 
offer the same relief in a dosage suitable for the young 



patient, in a pleasant-tasting chewable tablet. 

For everyone in the family, there is a member of the 
Coricidin family to bring real relief: Adult tablet forms 
packaged in the new, easy-to-use pop-out blister packs, 
spray, lozenges and a pleasant-tasting cough mixture. 

Recommend Coricidin. Your charges will be glad 
you did. For further information, consult your physician 
or write Schering Corporation Limited, Pointe Claire 
730, P.Q. 

• Reg. T,M. 



i 




Coricidin 



PEDIATRIC 



Coricidin 



THROAT ■ 
LOZENGE% 

soothing HONEY MEN 



Coricidin 



COLOTABLHS 




Coricidin 



COUGH MIXTURE 

iL_£i±t'n 'OUNCES 



N«Ml Child* Ptolaclrv* P*Oh 



Coricidin'D' 




MEDILETS* 



24 CHCWAtlf TAALTTS 

f ot fMt reltBl of 
chltdren'i ttuffy tod 
runny noMi du« to 
th« common cold 



Coricidin'D' 



tfOOMSIMT MTW 



24 TABLET^ 

tor ra4Mf of coW tyrtviom* 

•nd KCOmpAnying 




Coricidin 



MEDIIETS 




A Family of cold products. 




new products j 



Descriptions are based on information 
supplied by the manufacturer. No 
endorsement is intended. 




Bassinet Sheets 



Ornex 

Ornex, for the treatment of sinus con- 
gestion and sinus headache, is now 
available from Smith Kline & French 
Canada Ltd. It is a decongestant anal- 
gesic, combining acetaminophen and 
salicylamide (both with analgesic and 
antipyretic action) with phenylpropa- 
nolamine (nasal decongestant). 



Ornex does not generally produce 
drowsiness as it contains no antihis- 
tamines. Containing salicylamide, 
the risk of gastric side effects for pa- 
tients allergic or sensitive to acetyl- 
salicylic acid is avoided. 

The usual dose for adults is two 
capsules every four hours, and for 
children 10 to 14 years of age, one 



i 



I 




Cystometer 



22 THE CANADIAN NURSE 



capsule every four hours. Ornex, in 
bottles of 100, blue and white taper- 
end capsules, does not require a pres- 
cription. 

Smith Kline & French Ltd., 300 
Laurentian Blvd., Montreal 379, Que- 
bec will provide further information, 
on request. 

Saneen Bassinet Sheets 

Facelle Company's Saneen Bassinet 
sheets cost little enough for single use 
in the hospital nursery. Their size, 
strength, and softness, combined with 
disposability, make them the ideal 
substitute for nursery linen. 

Measuring 28" x 35", the sheets are 
large enough to cover the bassinet and 
allow for a good tuck-in, under either 
mattress or baby. They are made of 
two layers of cellulose tissue, rein- 
forced with strong, synthetic threads, 
and their softness eliminates any risk 
of irritation to a newborn's skir. 

Pre-folded for maximum conveni- 
ence, single-use Saneen bassinet sheets 
are poly-wrapped to ensure cleanliness 
and to facilitate storage and quantity 
control. 

For further information write to the 
Facelle Company Limited, 1350 Jane 
Street, Toronto 15, Ontario. 

Cystometer Gauges Bladder Function 

An air cystometer recently introduced 
by Modern Controls, Inc., provides a 
safe, rapid, and accurate method to 
evaluate bladder function. 

Because of its speed and because 
small cathers are used, the test pro- 
vides a practical clinical method to 
evaluate bladder function in infants 
and children. 

As air cystometry requires no prep- 
aration other than catheterization, the 
test may be performed in the ward, 
clinic, cystoscopic suite. 

The air cystometer provides a con- 
tinuous recording of intravesical pres- 
sure changes on a SVi" x 11" form, 
which later may be placed directly in 
th - patient's chart. Pertinent precys- 
» jmetric data, sensory changes, and 
che cystometric evaluation are also 
recorded directly on the cystometro- 
gram. The cystometer features a built- 
in mercury manometer for easy cal- 
ibration and variable flow rates from 
to 150 ml. per minute. An exchange- 
able fiber-tip pen assures a contin- 
uous recording free of ink skips. 

{Continued on page 24) 
MARCH 1971 



no OTHtR BflG PERFORfTU UH€ mC 



My safety chamber 
really stops retro- 
grade infection. 
Tttere's simply no way 
for the bugs to back 
up and go where they 
don't belong. And by 
tucking the BAC- 
STOP chamber in- 
side the bag, It can't 
be kinked acciden- 
tally to stop the flow. 



I'm clear-faced and 
easy to read. My white 
back makes my mark- 
ings stand out unique- 
ly, whether you look 
at my backbone scale, 
or tilt me diagonally 
to read small amounts 
with the corner cali- 
brations. 



II 



^. 



Cystofln* 

uiiMnt kM 



"« 



m 



^ 



I'm the unique new CYSTOFLO' drainage bag. a 
true-blue friend to nurses, physicians and patients. 
Why don't we get acquainted? 



My hanger Is the 
hanger that works 
well all the time. Hang 
it on a bed rail or a 
belt, it is always se- 
cure and comfortable. 
I'm always on the 
level with this hanger, 
whether my patient is 
lying, sitting, or walk- 
ing around. 



I«1 



I have the only shortie 
drainage tube around, 
and it's miles better 
than any other 
you ve ever used. It's 
easier to handle, and it 
won't drag on the floor, 
even with the new low 
beds. So out goes one 
more path to possible 
contamination. 



BAXTER LABORATORIES OF CANADA 

DIVISION Of TBAvtNQi LABORATORIES iNC 

6406 Nonham Onve Mallon Ontano 



your hospital is 
safer, operates more 
efficiently with TIME 

NURSING 
LABELS 



new products 




Safer because all Time Labels relating 
to patient care are BACTERIOSTATIC 
to assist in eliminating contact infec- 
tion between patient and nurse. The 
self-sticking quality of Time Nursing 
Labels eliminates the need for hand 
to mouth contact while working with 
patient record. 

More efficient because Time Nursing 
Labels provide you with an effective 
system of identification and communi- 
cation within and between departments. 

Time Patient Chart Labeis color-code 
your charts and records in any of 17 
colors with space for all pertinent pa- 
tient information. 

Time Chart Legend Labels alert busy 
personnel to important patient care 
divertives eliminating the possibility of 
error through verbal instructions. 

There are many other Time Labels to 
assist you in speeding your work and 
to assure accuracy in important pa- 
tient procedures. Write today for a 
free catalog of all Time Nursing Labels. 
We will also send you the name of 
your nearest dealer. 



(jfi. 



PROFESSIONAL TAPE COMPANY, INC. 

355 BURLINGTON RD., RIVERSIDE, ILL. 60546 



24 THE CANADIAN NURSE 



Complete information on the Mo- 
comMerrill Cystometer may be ob- 
tained from Modern Control, Inc, 
Minneapolis, Minnesota. 

Oratrast and Barotrast 

Oratrast (barium sulfate), pleasantly 
flavored for oral administration, pro- 
vides the prolonged and uniform coat- 
ing necessary to achieve films with 
excellent definition, even in the gastric 
antrum and duodenum. 

Barotrast (barium sulfate), a versa- 
tile barium preparation for rectal or 
oral administration, can be mixed to 
provide the density and viscosity needed 
for a wide variety of gastrointestinal 
studies. 

These radiological aids have been 
developed by the Barnes-Hind Labora- 
tories, P.O. Box 69, Adelaide Street 
Post Office, Toronto 1, Ontario. 

New Posey Catalog Now Available 

The latest Posey Catalog describes 
more than 200 items manufactured 
by the Posey Company. The publica- 
tion features a new material called 
Breezeline, a dacron mesh that is avail- 
able for all types of Posey safety vests. 

It includes 15 new items in its nine 
product sections: bed safety belts; limb 
holders; safety vests; wheelchair safety 
products; pediatric control products; 
safety belts for guerneys, stretchers, and 
operating tables; rehabilitation pro- 
ducts; orthopedic products; and miscel- 
laneous. An index is provided for easy 
reference. 

A free copy of the new 197 1 catalog 
may be obtained by writing the Posey 
Company. The Canadian distributor 
of Posey products is Enns & Gilmore 
Ltd., 1033 Rangeview Rd., Port Credit, 
Ontario. 




Pwsey Company «-,»».. 





Posey Catalog 



IV Storage Unit 
Storage Module for IV Solutions 

Market Forge has introduced a storage 
unit for intravenous solutions to be 
located next to the IV Preparation 
Station. Called FIFO (First In, First 
Out), the storage module simplifies 
rotation of IV bottles, thus assuring 
availability of fresh solutions. Bottles, 
held on inclined slides, are loaded from 
the rear by pulling out the entire FIFO 
unit. 

The IV Preparation Station itself 
is used in high IV usage areas such as 
recovery rooms, intensive care units, 
anesthesia workrooms, surgical and 
medical wards. It may also be used by 
an IV team, or in a pharmacy provid- 
ing centralized additive service. 

For information on the IV prep- 
aration station and its companion FIFO 
Storage Module, write Market Forge, 
1875 Leslie St., Don Mills, Ontario. 

Disposable Carafe 

The "Tempo" Carafe, a new liquid 
dispensing system for personal patient 
care, is sanitary and economical and 
is designed to simplify the work of 
paramedical personnel in hospitals, 
nursing homes, and other extended 
care facilities. 

The carafe has three components: 
body, cap, and molded base with handle. 
The body and cap are of expanded 
polystyrene to provide high insula- 
tion for hot or cold liquids. The base 
and handle components of polyethylene 
are molded into one piece to facilitate 
handling. 

The carafe, holding 32 ounces, is 
designed to be stacked and thus allow 
efficient jise of central supply storage 
space. 

Further information is available 
from The General Tire & Rubber Com- 
pany, Chemical/Plastics Division, I 
General Street, Akron, Ohio 44309. ■§> 

MARCH 1971 



Fleet 

ends ordeal by 

Enema 

for you and 
your patient 




Now in 3 disposable forms: 

* Adult (green protective cap) 

* Pediatric (blue protective cap) 

* Mineral Oil (orange protective cap) 

Fleet — the 40-second Enema* — is pre-lubricated, pre-mixed, 
pre-measured, individually-packed, ready-to-use, and disposable. 
Ordeal by enema-can is over! 

Quick, clean, modern, FLEET ENEMA will save you an average of 
27 minutes per patient — and a world of trouble. 

WARNING: Not to be used when nausea. In dehydrated or debilitated 

vomiting or abdominal pain is present. patients, the volume must be carefully 

Frequent or prolonged use may result in determined since the solution is hypertonic 

dependence. and may lead to further dehydration. Care 

CAUTION: DO NOT ADMINISTER should also be taken to ensure thai the 

TO CHILDREN UNDER TWO YEARS contents of the bowel are expelled alter 

OF AGE EXCEPT ON THE ADVICE administration. Repeated administration 

OF A PHYSICIAN. at short intervals should be avoided. 



Full information on request. I ^n^ ou.l,.v -M..M.ct>,T,c.L. 

•Kehlmann, W. H.: Mod. Hosp. 84:104, 1955 I f^^. 

FLEET ENEMA® — single-dose disposable unit 



T_-7 CAonfei&^noMt &.C'a 

p^J ItfWUWCMOWTStAU CANADA J 



tOijnoiD nv CJWAXut w mi 



MARCH 1971 THE CANADIAN NURSE 25 



March 11-12,1971 

University of British Columbia, Division of 
Continuing Nursing Education, Course on 
Maternal Health Nursing for practicing 
maternity nurses. Fee: $23.00. For further 
information write: Margaret S. Neylan, 
Associate Professor and Director, Univer- 
sity of British Columbia School of Nursing, 
Division of Continuing Education, Van- 
couver 8, B.C. 

March 15-16, 1971 

Workshop on Rituals and Routine, spon- 
sored by the New Brunswick Association 
of Registered Nurses, Fredericton, N.B. 
Leader of this workshop for head nurses 
will be Pamela E. Poole, nursing consultant. 
Hospital Insurance and Diagnostic Services, 
Department of National Health and Welfare. 

March 25-26, 1971 

University of British Columbia, Division of 
Continuing Education, Course on Psychia- 
tric Nursing for nurses providing care for 
psychiatric patients. Applications from 
other professions are welcomed. Fee: 
$23.00. For further information write: Marg- 
aret S. Neylan, Associate Professor and 
Director, University of British Columbia 
School of Nursing, Division of Continuing 
Education, Vancouver 8, B.C. 

March 31, 1970 

Canadian Nurses' Association annual 
meeting, business sessions only. Chateau 
Laurler, Ottawa, Ontario. 

Aprils, 1971 

Conference on cooperation in the health 
care of patients with cancer, in conjunc- 
tion with the Canadian Cancer Society, 
Ontario Division. Speakers will be Dr. 
Ruth E. Alison, Princess Margaret Hospital, 
Toronto ("Cancer Prevention and the 
Hopeful Outlook") and Dr. Elizabeth 
Kubler-Ross of Chicago ("Death and Dying"). 
Regiistration fee: $5.00. For further Infor- 
mation contact: Summer School and Ex- 
tension Department, The University of 
Western Ontario, London 72, Ont. 

April 17, 1971 

Homecoming for graduates of Stratford 
General Hospital, Stratford, Ontario. For 
further information contact: Mrs. Angus J. 
MacDermid Jr., President, Alumnae Asso- 
ciation, 204 Delamere Ave., Stratford. Ont. 

April 19-22, 1971 

Canadian Public Health Association, 62nd 
annual meeting, King Edward Sheraton 
26 THE CANADIAN NURSE 



Hotel, Toronto. For advance registration, 
information, and accommodation, write: 
CPHA Annual Meeting, 1255 Yonge Street, 
Toronto 7, Ontario. 

April 29-May 1, 1971 

Annual Meeting, Registered Nurses' 
Association of Ontario, Royal York Hotel, 
Toronto, Ontario. 

May 4-7, 1971 

Workshop on Test Construction for Teachers 
in Nursing Education to be conducted by 
Professor Vivian Wood. Tuition fee, includ- 
ing meals and accommodation: $120.00. 
For further information contact: Summer 
School and Extension Department, The 
University of Western Ontario, London 72. 

May 10-28, 1971 

Three-week intensive course in Developing 
Human Resources for Improved Nursing 
Care, offered for nurses who take respon- 
sibility for the work of others. It is designed 
to assist the nurse to improve her skills in 
fostering development of the abilities of 
individuals and work groups giving nursing 
care. For further information write: Continu- 
ing Education Program for Nurses, Univer- 
sity of Toronto, 47 Queen's Park Crescent, 
Toronto 5, Ont. 

May 11-14, 1971 

Alberta Association of Registered Nurses, 
annual meeting, Banff Springs Hotel, Banff, 
Alberta. 

May17-|une11,1971 

Rehabilitation Nursing Workshop, a four- 
week intensive course for registered nurses 
working in acute, general, and chronic 
illness hospitals, nursing homes, public 
health agencies, and schools of nursing. 
For further information write: Continuing 
Education Program for Nurses, University 
of Toronto, 47 Queen's Park Crescent, 
Toronto 5, Ontario. 

May 26, 1971 

Registered Nurses' Association of British 
Columbia, 59th annual meeting, Bayshore 
Inn, Vancouver, B.C. 

May 30-June 1,1971 

Manitoba Association of Registered nurses, 
annual meeting, Dauphin, Manitoba. 

June 1971 

Reunion in conjunction with the closing of 
St. Joseph's General Hospital School of 
Nursing, Vegreville, Alberta. For further 
information contact: Sister Mary Ellen 



O'Neill, Alumnae President, St. Joseph's 
General Hospital, Vegreville, Alberta. 

June 2-4 1971 

Canadian Hospital Association, National 
convention and assembly, Queen Elizabeth 
Hotel, Montreal, Quebec. 

|une 6-11, 1971 

Canadian Orthopedic Association, annual 
scientific and business meeting, Jasper 
Park Lodge, Jasper, Alberta. For further 
information write: Carroll A. Laurin, Cana- 
dian Orthopedic Association, Suite 619, 
3875 St. Urbain St., Montreal 131, P.Q. 

June 7-11, 1971 

Canadian Medical Association, 104th an- 
nual meeting. Nova Scotia. For further 
information: Mr. B.E. Freamo, Acting 
General Secretary, Canadian Medical 
Association, 1867 Alta Vista Drive, Ottawa 
8, Ontario. 

June 11-13, 1971 

Reunion of the Kingston Psychiatric Hos- 
pital School of Nursing graduates. For 
further information write: Mrs. N. R. Fer- 
guson, 312 College St., Kingston, Ontario. 

June 16-19, 1971 

Canadian Congress of Neurological Sci- 
ences, sponsored by the Canadian Neuro- 
logical Society, Canadian Neurosurgical 
Society, and the Electroencephalography 
Society, St. John's, Nfld. Further informa- 
tion available from: Dr. J. Hudson, Secretary, 
Canadian Neurological Society, Victoria 
Hospital, London, Ontario. 

June 21-23, 1971 

Seventh annual conference. Operating 
Room Nurses of Greater Toronto, Royal 
York Hotel, Toronto, Ontario. Enquiries 
may be directed to: Miss Marilyn Brown, 
2178 Queen St., E., Apt. 4, Toronto 13, Ont. 

July 8-10, 1971 

Reunion and Saskatchewan Homecoming, 
St. Paul's Hospital Nurses' Alumnae. Send 
addresses and enquiries to: Mrs. Rita 
Taylor, 433 Ottawa Ave. South, Saskatoon, 
Saskatchewan. 

July 24-25, 1971 

Alumnae reunion for graduates of St. 
Joseph's Hospital School of Nursing, 
Saint John, N.B., in conjunction with closing 
of the nursing school. Please contact: 
Sister A.M. McGloan, St. Joseph's Hospital, 
Saint John, N.B. §■ 

MARCH 1971 



I 





HCWSTHIS FOR OPENERS? 



It's nice when you can peel the metal cap off a glass bottle of 
intravenous solution with just your fingers. But all too often, it pre- 
sents a risk to the nurse who does it. The raw metal edge you 
leave behind can result in a cut finger. Painful? Of course, and 
time-wasting too. viaflex plastic containers for intravenous solu- 
tions have abolished this hazard. You don't have to fumble with 
twist-off caps or risk the sharp edges of tear-off caps. This 
makes set-ups and changeovers easier, faster, safer. And the 
containers are shatterproof, so they may be dropped on the 
floor without danger of smashing. Since the containers are much 



lighter and easier to handle than glass bottles, one nurse can 
easily carry several containers. Sterility is easier to maintain with 
the VIAFLEX system, too, because the system is completely closed. 
Additives can be added swiftly, surely, without danger of con- 
tamination, with the VIAFLEX exclusive self-sealing ports. There 
is no vent, so airborne contaminants cannot get 
into the system, viaflex is the first and only 
plastic container for intravenous solutions. For 
easier, faster, safer procedures, it's the first and 
only solution container you should consider using. 




BAXTER LABORATORIES OF CANADA 



DIVISION OF TRAVENOL LABORATORIES INC 

6405 Northam Drive, Malton. Ontario 



D 

Viailex 



in a capsule 



Chuckle 

Dr. Roch Martin sent the following 
story to Canadian Doctor, which pub- 
lished it in its November 1970 issue. 
We don't know whether or not the anec- 
dote is true, but it's good for a chuckle. 
"A patient suffering from a perianal 
abscess was advised by his physician 
that he required surgery. He agreed 
readily, but asked for a heart check-up 
first. 'There is no use repairing the 
muffler if the engine is no good,' he 
reasoned." 



How did he miss it? 

The Globe and Mail asked this ques- 
tion in a recent editorial, after congrat- 
ulating novelist Morley Callaghan 
"on surviving the clubbing dished out 
by a burglar and eventually putting 
him to flight by lifting a heavy oak 
chair — the first weapon that came to 
hand. 

"It distresses us, however," the edi- 
torial continues, "that a man of Mr. 
Callaghan's acute perception should 
have missed the early warning signal 




28 THE CANADIAN NURSE 



of the whole affair. The man introduced 
himself as a tax collector and proferred 
a card. While reading the card, Mr. 
Callaghan was attacked. Surely any- 
one confronted with a tax collector 
knows right away he is dealing with a 
robber and should instantly reach for 
the nearest oak chair instead of fussing 
with cards." 



It's still the birds and bees 

In an area where there are several ski 
resorts, one has a children's ski program 
called the ski-birds and another's pro- 
gram is called the ski-bees. It was bound 
to happen that a child from one group 
would get mixed up and board the 
wrong bus. After some confusion the 
child was finally located and returned 
to the proper slopes. The ski director 
commented, "Perhaps now he'll know 
about the birds and bees." 



Appropriate 

Between Ourselves, a bulletin published 
for the staff of the Douglas Hospital in 
Verdun, Quebec, tells of the psychiatrist 
who had two baskets on his desk. One 
was marked "Outgoing" and the other 
"Inhibited." 

On talking to plants 

Studies have been published showing 
that plants flourish with equal doses 
of light, water, fertilizer, and tender 
loving care. Apparently the attitude 
of the gardener affects the growth rate 
of plants. Plants who feel loved and 
appreciated respond with an out-pour- 
ing of vegetation. 

One plant of our acquaintance was 
inadvertently exposed to a window 
draft and showed its misery by drooping 
and shriveling. With apologies and 
expressions of concern, the owner put 
it in a more comfortable spot and now 
waits to see if the plant sensed her 
sincerity. 

Both Mrs. and Miss outdated 

Arbiters of etiquette tell us that a 
woman's signature should not indicate 
whether she exists in a state of married 
or unmarried bliss, but the eye is still 
caught when Mrs. receives a letter 
addressed Miss. The problem of such 
business faux pas can be eliminated by 
the use of the letters Ms. to take in 
both categories. ^ 

MARCH 1971 



for use 
-on the ward 
-in the OR 



-in training 



NEOSPORir 

IRRIGATING 

SOLUTION 

Available: Sterile Ice Ampoules. 
Boxes of 10 and 100 

INSTRUCTIONS FOR USE 

This piepaistion is specifically designed fo> use i*ilh 5 cc. 
■mree-w»y" catheieis Of WTth other cathete* systems peimii- 
Ting continuous 'mgation of the urmary bladdet 

1 PREPARE SOLUTION 

Using stenle precautions. on« (1 ) CC of NKXponn Irriga- 
ling Solution shooid b* added to • 1.000 cc bonie of 
starila isotonic salina solution. 

2 INSERT INDWELUNG CATHETER 

Calhelefiie the patient using full stenia precautions. The 
use of an antibacterial lutxicant tuch as Lubasponn* Urethral 
Antibacterial Lubricant is recommerxled durir>g insertion of 
the caineter 

INFLATE RETENTION BALLOON 

Fill a Luer Type lynr^ge Mith 10 cc of steiile water or Mline 
(5 cc for balloon, the lemainder to compensate for the 
volume required by the inflation channel) Inaert syringe 
tip into valve of balloori lumen, m^ea solution and remove 
^ synge 

pONNECT COLLECTION CONTAINER 

e outflow (diamsge) lumen should be asepticalty con- 
^cted. via a sterile disposable plastic tube, to • sterile 
Lposable plastic collection bag (bottle). 

[tACH rinse SOLUTION 

inflow lumen of ttie 5 cc "three-way" catheter shouM 
e connected to the bonie of diluted Neosponn 
}ation Solution using sterile technique. 

IJUST FLOW-RATE 

most patients inflow rate of i^e diluted Neosporin 
rrigating Solution should be adjutted to a slow drip to 
deliver atwul 1.000 cc every iwenty-tou' hours [about 
40 cc per houi) If the patient's unne output exceeds 2 
liters per day it is recommended that the inflow rate be 
adjusted to deliver 2.000 cc ol the solution m a twenty 
four hour period. This requires the addition of an ampoule 
of Neosporin Irrigating Solution to each of two 1.000 cc 
bottles of sterile saline sotuiion. 

I KEEP IRRIGATION CONTINUOUS 

It IS imponant that irrigation of'the Wedder be continuous 
The rinse bottle should never - ■ 
inflow drip mlenupted for mo 
outflow tube should always b 



I Convenient product identifying labels for use on bottles 
of diluted Neosporin Irrigating So(utioi% are availabte m e»ch 
ampoule paclcing or from yoM B. W. ft Co.' Representative 



Burroughs Wellcome & Co. (Canada) Ltd. 









Neosporin' Irrigating Solution 



INSTRUCTIONS FOR USE 



Designed especially for the nursing pro- 
fession, this Instruction Sheet shows 
clearly and precisely, step by step, the 
proper preparation of a catheter system 
for continuous irrigation of the urinary 
bladder. The Sheet is punched 3 holes to 
fit any standard binder or can be affixed 
on notice boards, or in stations. 

For your copy (copies) just fill in the cou- 
pon (please print) noting your function or 
department Within the hospital. 



Dept. S.P.E. 

Burroughs Wellcome & Co. (Canada) Ltd. 

P.O. Box 500. Lachine. P.O. 

Gentlemen : 

Please send me I 1 copy (copies) of the N.LS. Instructions for Use. My department or function 



within the hospital is_ 



NAME. 



ADDRESS. 



CITY OR TOWN. 



.PROV. . 



■JradP Mark 

vlARCH 1971 




Burroughs Wellcome & Co. (Canada) Ltd. 



THE CANADIAN NURSE 29 



A ward-winning 
combination 



With Dermassage, all you add is your soft 
touch to win the praises of your patients. 

Dermassage forms an invisible, 
greaseless film to cushion patients 
against linens, helping to prevent 
sheet burns and irritation. It protects 
with an antibacterial and antifungal 
action. Refreshes and deodorizes 
without leaving a scent. And it's 
hypo-allergenic. 

Dermassage leaves layers 
of welcome comfort on 
tender, sheet-scratched f _ 
skin. And there's another 
bonus for you: While 
you're soothing patients 
with Dermassage, you're 
also softening and \ 

smoothing your hands. \ 

Try Dermassage. \ 
Let your fingers jf 

do the talking. 



MEDICATED 



H 



HH 



M 



. Uikeside Laboratories (Canada) I,t<l. 
G4 Colgate Avenue. Toronto 8. Ontario 



*Tra(le mark 



Health is everybody's business 



The author, known internationally for her many contributions to nursing, was 
granted the honorary degree of Doctor of Laws at the University of Western 
Ontario's May convocation. This article is adapted from the address Dr. 
Henderson gave at that time. 



Virginia A. Henderson, R.N., B.S., M.A., LLD. 



When a friendly secretary was typing 
my answer to the letter that told me 
what would happen this afternoon, she 
said, "Miss Henderson, if you are to 
speak to all these people, won't you 
have to say something sort of univer- 
sal?" I said, "'Yes, absolutely global!" 
Then she said, "Don't you think you'd 
better start writing your speech today?" 
My answer — that it would make no 
difference, that it would sound just 
the same whether I wrote it in March 
or just before I came to the University 
of Western Ontario in May — seemed 
to depress her — as, in fact, it did me! 
Since then I've been to meetings 
from Boston to Miami and in between. 
Many of the addresses have dealt with 
"global" topics such as war and peace, 
overpopulation, pollution, racial antag- 
onisms, the generation gap, and drug 
abuse. If I were someone like Lady 
Barbara Ward Jackson, Dr. Mark 
Inman, or Dr. Choh Ming Li, I might 
use the few minutes I have with you 
to speak on one or more of these sub- 
jects. Like everyone else, I consider 
them of overriding importance. 

Dr. Henderson, a graduate of the Army 
School of Nursing. Washington. D.C.. 
and Teachers College, Columbia Univer- 
sity. New York, is Research Associate 
and Director of the Nursing Studies Index 
project in the School of Nursing at Yale 
University, New Haven. Connecticut. 



MARCH 1971 



In case you think this just talk, I 
present the following evidence of my 
"involvement" (the term used today). 

For as long as I can remember I've 
been an avowed pacifist. Believing, 
as I do, that every person is a mixture 
of constructive and destructive forces, 
I think it wrong to put a man or woman 
in a situation where he must either kill 
or be killed. I subscribe to the view 
that warfare is legalized murder. This, 
in a fashion, takes care of war and 
peace. 

To dispose of overpopulation, I 
merely report that I am childless, ex- 
cept for the foster children I claim as 
a doting aunt and a teacher devoted 
to many students. 

To demonstrate my horror of pollu- 
tion — I've never smoked or even 
owned a car. 

To illustrate my belief in racial 
equality and my faith in the younger 
generation. I might list a variety of 
experiences. But I will confine myself 
to one; On the invitation of five of our 
graduate nurse students, I went to 
Washington with them several weeks 
ago to talk with senators and congress- 
men about our mutual concern over 
what is happening in the United States 
Government, especially as it affects 
youth and equal opportunity for all 
races. 

Finally, to dispose of the topic of 

drug abuse, I'll merely say that by the 

THE CANADIAN NURSE 31 




grace of God, I've escaped addiction. 
I think this may be because I have 
believed suffering — for others, as 
well as for oneself — to be inescapable. 
I know what Dr. Albert Schweitzer 
meant when he said he had never known 
a happy day in his life. I suppose 1 don't 
"take trips" because I accept the pres- 
ent reality and want to stay right here 
braced for it. I am not a "pleasure seek- 
er," as I tend to enjoy work, find it 
rewarding, and, in fact, indistinguisha- 
ble from play. 

None of this should be interpreted 
as advice. A remark on parental advice 
made by a cousin of mine has persuaded 
me to avoid anything that smacks of it. 
32 THE CANADIAN NURSE 



She told me that once when she was 
telling her daughter she had used too 
much makeup, she mentally heard her 
mother saying exactly the same thing 
to her when she was her daughter's 
age. It occurred to my cousin that pa- 
rental advice is a "keepsake" — some- 
thing one values, in a way, but doesn't 
use, so it is passed on, in mint condi- 
tion, to the next generation. The oft- 
quoted speech of Polonius to Laertes 
is most convincingly interpreted as a 
string of platitudes, collected over the 
centuries, to be delivered by oldsters 
to youngsters who listen only for the 
inflection that suggests the end of the 
speech. 



But, instead of telling you what I'm 
not going to talk about, it might be more 
to the point to tell you the subject of 
this brief address. Because you have 
cited me for my york in health promo- 
tion and the care of the sick. I think it 
appropriate to say something about 
health — especially the contribution 
the nurse makes, or could make to it. 
Actually, this topic is just about as 
"global" as those I have dismissed, and 
you will see that nursing — as I inter- 
pret it — includes them. 

Although it is the fashion — at least 
in the United States — to talk about 
"delivery of health services" and the 
roles of the so-called "professionals," 

MARCH 1971 



"paraprofessionals," and '"indigenous 
workers" (and nursing personnel fall 
into all these classes), I believe even 
these terms fail to stress the most im- 
portant health concept. They leave out 
the role of every man — the patient or 
client with whose health the whole 
argument is concerned. 

The first questions to be asked about 
health in each society are: do its people 
value human life and do they value 
health as a quality of life? 

When a society such as ours in the 
United States spends about half of its 
public funds on its military program, 
and more of its national income on 
tobacco, liquor, narcotics, and cosmetics 
than it does on education or health; 
when it grossly pollutes its urban envi- 
ronment and distributes its food sup- 
plies so unequally that some are hungry 
— no amount of health care that all 
health workers combined can "deliver" 
can be more than the application of a 
"Band-Aid" to a hemorrhaging artery 
of the society. 

In other words, 1 am saying that 
respect for life — and health as a qual- 
ity of life — is firry mans business 
and his most important business. 

Collectively, a society must learn 
how to protect and conserve life, to 
value a sane mind in a healthy body. 
The "professionals" and "paraprofes- 
sionals" cannot "deliver" health to a 
society. What health workers do as 
citizens to create a world in which life 
is conserved and health valued, is more 
important than their services to those 
in life's crises and the loveless custodial 
care they offer the chronically ill and 
dependent. 

Those of us in today's so-called west- 
ern culture are proud of having extended 
the average life span by more than 20 
years since 1900. Doctors and nurses, 
the principal "deliverers" of health 
care, tend to point to this accomplish- 
ment as evidence of a successful system 
of medical care. But should they? 

The average life span in the United 

MARCH 1971 



States, for example, has risen from 
about 50 years in 1900 to about 71 
years in 1969, chiefly because infant 
mortality has dropped dramatically and 
because children die far less often from 
infectious diseases in this century than 
in the last. This drop in infant and 
child mortality is not so much because 
doctors and nurses have given good 
medical and nursing care to infants 
and children, but because the water 
they drink and the food they eat is 
cleaner, and because protective sera, 
antibiotics, and specific drugs have 
been developed to protect the young 
against the pathogenic organisms that 
in the last century could, and sometimes 
did, wipe out even large families. 

Those who have so greatly increased 
the life span therefore include not only 
doctors and nurses, but bacteriologists, 
chemists, sanitarians, and legislators 
— all who have identified dangers in 
the environment, developed controlling 
agents, and devised protective legisla- 
tion. Credit is also due biological scien- 
tists and educators who have raised the 
general level of nutrition. 

Children of this age talk knowingly 
about food values, about protecting 
teeth from decay and, in fact, about 
health hazards and health practices 
that were unknown to our great-grand- 
parents. What American school child, 
for example, would not be aghast to 
see a doctor spit on his boot, sharpen 
a knife, wipe it off and lance a boil? 
Yet, I'm told this is what the country 
doctor did when he treated the boys 
in my grandfather's school. 

What child of today has not heard 
the danger of air pollution discussed? 
A six-year old friend of mine said to 
her brother, who was wishing dire 
disaster on her as a result of a quarrel, 
"I wish I was pollution and you had 
to breathe me." 

Health care is indeed the business 
of every person. It is the business of 
the humanist; the philosopher; the 
priest; the physical, biological or social 



scientist: the physician to man and 
beast; the specialist in any branch of 
therapy; the nurse; the educator; the 
legislator; and the parent and child. 

I believe promotion of health is far 
more important than the care of the 
sick. I believe there is more to be gained 
by helping every man learn how to be 
healthy than by preparing the most 
skilled therapists for service to those 
in crises. 

As a member of five committees — 
national, regional, and local — all 
working to improve health science 
libraries, I listen to endless discussions 
of their functions. Some of us on these 
committees believe that every citizen 
should have access to what is known 
or has been written about the science 
and art of keeping well, curing disease, 
adjusting to a necessary limitation of 
living, or dying well when the time 
comes. Other members of these li- 
brary committees seem to consider 
the medical library the possession of 
a guild that guards its secrets! Oppo- 
sing the idea of the medical library 
as a public institution, one physician 
said, "We have enough trouble with 
our patients who ask for treatments 
described in the Readers Digest!" 

Fortunately, there are always other 
members of these library committees 
who believe as I do that the goal of 
every health worker should be to help 
those they serve acquire or regain their 
independence. The great beauty of 
medicine, to my mind, is its ethical 
principle of cooperation as oppwsed 
to the industrial principle of competi- 
tion. A medical worker does not patent 
and protect his discovery, but freely 
shares the knowledge and skills he 
develops with all who can use them. 

So, in discussing health and health 
service, I believe the concept that the 
average man has of health will deter- 
mine the future. Each of us will strive 
for what, in our hearts, we value most. 
We are each the hero or anti-hero of our 
lives, and the best doctor or the best 
THE CANADIAN NURSE 33 



nurse can only help us reach the goal we 
set ourselves. 

For every health team (another pop- 
ular term) the patient is really the cap- 
tain: if he wants to stay sick or die, 
the rest of the team is nearly impotent. 
So all health workers are actually assist- 
ants to the patient. 

Under our western system of medi- 
cine, the physician is best prepared 
to help the patient identify the nature 
of his illness or handicap and to develop 
the most effective therapeutic plan or 
regimen with him, his family, the 
nurses, the social workers, and others 
who know the patient and his setting. 
I hope that some day all countries will 
have enough physicians to go around; 
at present the corner druggist is often 
the poor man's doctor in the United 
States. Some physicians there — and 
here too, I believe — would like to 
turn over certain categories of patients 
to nurses — specifically, the well child, 
the chronically ill and aged, and those 
who must be visited in their homes. 

In Russia, physician's assistants or 
"feldshers" share responsibility for 
diagnosing disease and prescribing 
therapy. Physicians (more than three- 
quarters of them are women) supervise 
the feldsher and the nurse. In Russia, 
nurses have no autonomy and there is 
no nursing profession. In other countries 
where western medicine is practiced, 
the physician is the authority on cure 
and the nurse, the expert on care. 

In 1934, Ira A. Mackay, then dean 
of arts and sciences at McGill University 
in Montreal, spoke of these two essen- 
tials: care (by the nurse) and cure (by 
the physician). He added, "I do not 
know which is nobler." 1 would say, 
I do not know which is more necessary 
— or which is more difficult. 

I see nursing as a highly complex 
service demanding broad social exper- 
ience and a continuing study of the 
physical, biological, and social sciences. 
I believe it is the nurse's unique function 
to help the individual, sick or well, 
34 THE CANADIAN NURSE 



to carry out those activities contributing 
to health or its recovery, or to a peace- 
ful death that he would perform un- 
aided if he had the necessary strength, 
will, or knowledge. I believe the nurse 
should fulfill this function in homes, 
hospitals, schools, industries, prisons, 
ships, or anywhere else, whether or not 
a physician is in attendance. 

This is an elastic definition, as there 
is infinite variety in the needs of individ- 
uals and the circumstances under which 
they must be met. The nurse may have 
to help a woman deliver her baby, help 
pass a tube into an asphyxiated man's 
windpipe, or even perform a tracheot- 
omy. It includes helping a patient decide 
whether or not he needs a physician. 

If a physician sees a patient and 
prescribes for him, the nurse must help 
the patient understand, accept, and 
carry out the treatment. Notice I do 
not say the doctor's orders, for I ques- 
tion a philosophy that allows a phy- 
sician to give orders to patients or other 
health workers. 

The nurse's role as just described, 
requires her to know the patient; to 
get inside his skin, assess his physical 
and emotional needs; to walk for him 
if he is bedfast; to speak for him if he 
is mute, or unconscious; to protect him 
if he is suicidal until she can help him 
regain his love of life. 

When we consider the difficulty of 
maintaining our own physical and emo- 
tional balance, we must see that help- 
ing others to do it is indeed a complex 
service. The nurse must constantly 
assess the patient's need for strength, 
will, or knowledge and know how to 
withdraw this complement of any one 
of them, so that he gains or regains his 
independence as soon as possible. The 
nurse must tailor her service to the 
patient's chronological and intellectual 
age, his life experience and setting, his 
values, his temperament and the lim- 
itations imposed by his handicap or 
illness. Since, in addition, she must help 
the patient or client understand and 



carry out the prescribed therapy, the 
nurse must be a continuing student of 
medicine, for she can teach only what 
she knows. 

Summary 

Although I did not pretend to speak 
as an authority on any of the major 
threats to human well-being, 1 did admit 
to a deep concern about them and ven- 
tured to say that what each o.' us does 
as a citizen to help create a world in 
which life, and health as a quality of 
life, is valued, is as important — per- ] 
haps more important — than the nar- ' 
rower task we each set for ourselves ' 
as members of a profession or occupa- 
tion. 

However, those of us who elect the 
ministry, nursing, or medicine occupy 
a privileged place in society, for it 
never asks us to perform a destructive 
act. On the contrary, we are expected 
to help the sinner as we might the saint, 
to serve the hypothetical enemy as we 
might our own people. We profess a 
non-judgmental cooperative ethic, 
which, if generally adopted, might 
transform society. 

Mark Twain, in some of his more 
audacious writings, published posthu- 
mously, seems to despair of the human 
race. However, he described a brief 
period of history when "bottled 
thought" was available to all, and dur- 
ing this period there were no wars. He 
claimed the formula was lost and with 
it all its beneficent effects. But here, 
I think, he left out of his argument the 
power of emotion. 

If society needs "bottled thought," 
it also needs "bottled compassion." 
Thought without emotion is cold and 
harsh, and emotion without thought 
is maudlin. If we could bring into public 
affairs the ethical concepts health work- 
ers profess, we might have justice tem- 
pered by mercy. And no individual or 
nation would be considered outside the 
pale, as far as our obligation to help 
is concerned. § 

MARCH 1971 



Mind-body relationships in 
gastrointestinal disease 



Often it is difficult to demonstrate a causal relationship between a patient's emotional 

upset and the disease state. The author describes this complexity and some of the 

diseases believed to be caused or aggravated by emotion. 



D. |. Buchan, M.D., F.R.C.P. (C) 



Emotional upset, such as worry or fear, 
has been recognized as a cause of gas- 
trointestinal disturbances in literature 
and folklore for centuries. In the twen- 
tieth century, beginning with the work 
of Professor Cannon and his colleagues 
at Harvard, attempts have been made 
to relate more closely specific emotional 
upsets or personality characteristics 
to gastrointestinal diseases. These 
attempts have been imperfect because 
of the complex nature of the problem. 
The relationship is often seen in the 
clinical situation as the simultaneous 
occurrence in time of an emotional 
disturbance and a gastrointestinal dis- 
ease or symptom. 

There are three possible explana- 
tions for this simultaneous occurrence: 
first, the emotional event caused the 
gastrointestinal upset; second, the gas- 
trointestinal upset caused the emo- 
tional upset; or third, there was no 
causal relationship between the two. 
We see all three situations occurring 
in patients with gastrointestinal com- 
plaints, and appropriate management 
of the patient's problem depends on 
the accurate recognition of which situa- 
tion is present. 

The problem is complicated by the 
variety of bodily responses to an emo- 
tional upset or life stress. This response 
may be seen as a change in organ struc- 
ture or a change in organ function 
without any recognizable structural 
change. We tend to call this latter type 
MARCH 1971 




Dr. Buchan is with the Department of 
Medicine. University of Saskatchewan. 
Saskatoon, Saskatchewan. 

of resfxjnse "functional" or "neurotic," 
depending on our own orientation and 
value judgments. 

The psychological disturbance in 
other circumstances leads to changes 
in organ structure, a process commonly 
referred to as "psychosomatic." Actu- 
ally, it is incorrect to view the patients 
response as either "psychic" or "somat- 



ic" exclusively, as the total response of 
any patient is usually compounded of 
both psychic and bodily elements in 
varying degrees. It may be of some help 
in understanding and dealing with the 
patient's gastrointestinal problem to 
decide whether the psychological prob- 
lem initiated structural bodily change, 
or whether some change in body struc- 
ture caused a change in the patient's 
psychological responses. 

The study of psychosomatic diseases 
of the gastrointestinal tract has been 
difficult because of our inability to 
demonstrate a causal relationship be- 
tween the emotional upset and the 
disease state. We have no final proof 
that the diseases discussed in this ar- 
ticle are psychosomatic; however, 
clinical experience seems to indicate 
that in these states an emotional com- 
ponent is often a major factor and, as 
such, should be recognized and if 
possible dealt with adequately. 

In most psychosomatic diseases in 
which there is a definite structural 
change, such as ulcerative colitis or 
duodenal ulcer, controversy has arisen 
about the nature of the process, with 
mechanisms other than psychologic 
being implicated by some observers. 
It is possible those symptoms consid- 
ered functional are due to a molecular 
disturbance that is not seen as a change 
in structure by our present diagnostic 
methods. A significant practical im- 
plication of structural change is that 
THE CANADIAN NURSE 35 



PSYCHIC 
FACTORS 




SOMATIC 
FACTORS 



PATIENT A 



ENTB 



in most cases it carries a more serious 
prognosis of morbidity or mortality 
than purely "functional" syndromes. 

An important concept in understand- 
ing the cause of psychosomatic diseases 
is that of variation of the contribution 
of psychic or somatic factors in any 
given patient. The figure above illus- 
trates this concept. Patient A, with any 
given disease, such as ulcerative colitis, 
may be thought of as having major psy- 
chologic components — for example, 
the loss of an important figure — and 
minor somatic components. Conversely, 
Patient B has minor psychological fac- 
tors and major somatic factors, such 
as hypersensitivity, genetic predisposi- 
tion, and so on. Such a scheme can be 
expanded to include in the psychic ef- 
fects, social and cultural factors; and 
on the somatic side, genetic predis- 
position, hypersensitivity, and physical 
environmental factors leading to tissue 
change. 

The following discussion will deal 
first with those situations in which 
there is no structural change, that is, 
functional gastrointestinal responses 
and, second, where structural change 
is present either as a consequence ot 
emotional factors or as a cause of psy- 
chological upset. 

Functional Gl syndromes 
without change in organ structure 

Glossodynia 

Sore or burning tongue without 
evidence of any change in the epithel- 
ium of the tongue is seen most frequent- 
ly in middle-aged women. It is often ac- 
companied by some evidence of depres- 
sion and occasionally by decreased 
salivary flow. Antidepressive drugs 
or tranquilizers may help, but the symp- 
tom tends to persist. 
36 THE CANADIAN NURSE 



Disturbances in Swallowing 

Globus hystericus is characterized 
by complaints of a sense of constriction 
or a "lump" in the throat not unlike 
that associated with grief. There is 
difficulty in a "dry" swallow, but none 
with either solid foods or fluids. 

Diffuse esophageal spasm leads to 
temporary difficulty in swallowing 
foodstuffs and often burning retro- 
sternal pain. This may occur in sit- 
uations the patient is unable to accept 
or, in organ language, "to swallow." 

Aerophagia 

Excessive gaseousness with swallow- 
ing of air and often loud belching is 
most often a functional symptom. Al- 
though traditionally "flatulent dyspep- 
sia" is associated with gall bladder dis- 
ease, patients with aerophagia and 
belching as the main symptoms are 
seldom found to have organic disease. 

Psychogenic Vomiting 

Nausea and vomiting accompany a 
variety of emotional disturbances and 
are rarely severe enough to threaten 
life by loss of potassium with conse- 
quent hypokalemia and muscular paral- 
ysis. Pernicious vomiting of pregnancy 
may be a psychologic rejection of that 
pregnancy; conversely, psychogenic 
vomiting may accompany pseudocyesis 
or false pregnancy in some patients. 
Occasionally a husband responds to his 
wife's pregnancy by vomiting in the 
morning. 

Disturbances of Food Intake 

Anorexia nervosa, in which food 
intake may be reduced by refusal to 
eat or by induced vomiting, is a well- 
recognized syndrome in adolescent 
girls. Psychologically it appears to be 
a rejection of the feminine role by 
inducing a malnourished, non-feminine 



body image and amenorrhea. The 
indifference of the patient to her obvi- 
ous wasting is characteristic, with com- 
pulsive exercising adding to the weight 
loss. 

One of the commonest causes of 
decreased appetite and weight loss 
is depression. In any patient with these 
symptoms, the other characteristics of 
depression, such as feelings of guilt 
and worthlessness, early morning wak- 
ing, and constipation, should be sought. 

There are many minor forms of 
appetite suppression caused by psycho- 
logic factors. The "picky" eater, both 
in child and adult forms, may attempt 
to dominate and influence others in his 
environment by food rejection and a 
failure to thrive. 

Abdominal Pain 

There are many varieties of abdom- 
inal pain associated with psychological 
upheaval, but only a few will be dealt 
with here. Motility disturbance of the 
stomach with increased tonus is ac- 
companied by epigastric burning, in- 
distinguishable from that caused by 
peptic ulcer. 

Steady pain, particularly at the co- 
lonic flexures, may be associated with 
irritable colon ; other patients sometimes 
have diarrhea and suffer more from 
intestinal colic. These abdominal pains, 
which seem to be related to motility 
disturbances, are sometimes referred 
to as "imaginary," but may be severe 
enough to lead to narcotic addiction. 

Disturbances of Colonic Function 

The syndrome called irritable col- 
on is thought to be due in part to factors 
of tension and anxiety, and is charac- 
terized by diarrhea, constipation, ab- 
dominal pain, and excess mucus in the 
stools. Any of these symptoms may 
be present alone or in combination. 
Frequently the bowel symptoms are 
only part of a multi-system response 
to stress, with headache, chest pain, 
palpitation, and so on, also present. 

Constipation may occur alone, with- 
out any other irritable colon symptoms; 
it often is found in patients who are 
precise, over meticulous, and constrict- 
ed in their approach to life. As noted 
previously, constipation may be the 
presenting symptom in the depressed 

MARCH 1971 



patient who is middle-aged or elderly, 
and is best treated by relief of the de- 
pression. 

Psychosomatic diseases 

with change in organ structure 

The first group consists of diseases 
that seem to follow or are caused by a 
psychological disturbance. These dis- 
eases include duodenal ulcer, ulcerative 
colitis, regional enteritis, and celiac 
disease. 

Duodenal Ulcer 

The evidence for some relationship 
between stress and duodenal ulcer is 
derived from experimental studies, 
epidemiological surveys, and clinical 
experience. Experimental studies on 
human gastric function have shown 
that emotions, such as anger, hostil- 
ity, and resentment, may increase the 
secretion of hydrochloric acid and 
susceptibility of the mucosa to ulcera- 
tion. As patients with duodenal ulcer 
show, on the average, double the hydro- 
chloric acid secretion than normal, it is 
believed that stress may cause ulcer 
by increased hydrochloric acid secretion 
and decreased mucosal resistance to 
ulceration. 

Studies of population groups in- 
volved in stressful occupations or sub- 
jected to increased environmental stress 
provide some evidence of an increased 
incidence of peptic ulcer. Clinical 
studies have shown in some patients 
with duodenal ulcer the onset and ex- 
acerbation of their disease with stress. 
Some attempts have been made to 
define a "personality type" in patients 
with ulcer, but this has been unsuc- 
cessful. 

Ulcerative Colitis 

The literature on the relationship 
of life stress to ulcerative colitis is 
extensive but inconclusive. There are 
studies of individual patients that 
describe conflicts over dependency 
with consequent hostility being related 
to the onset of colitis. Others have 
described the loss of an impwrtant figure 
in the patient's life as a precipitant of 
this disease. Recent studies of large 
groups of patients with colitis seem 
to indicate that these patients are no 
different, either qualitatively or quanti- 
MARCH 1971 



tatively, in their response to life stress 
than a control group. 

The patient with colitis often displays 
an inability to establish meaningftil 
relationships with others, hostility, 
excessive dependency, and depression; 
but whether these charactristics are a 
cause of the disease or a result remains 
unresolved. Certainly some of these 
characteristics, such as depression, 
disappear with succesful medical or 
surgical treatment of the colitis. The 
present position of regional enteritis as 
a stress-related disease is much the 
same as ulcerative colitis. 

Celiac Disease 

Some have claimed that exacerba- 
tions of celiac disease are related to 
stress. However, the underlying prob- 
lem is the genetically-determined sen- 
sitivity of the small bowel epithelium 
to the cereal protein, gluten, in the 
diet. Since this predisposition persists 
throughout life despite periods of good 
health without symptoms, stress may 
indeed be the added factor causing 
symptoms. 

Organic Disease 

With Psychologic Manifestations 

The second group consists of dis- 
eases with structural changes that lead 
to psychological symptoms. As noted 
before, some of the psychological symp- 
toms in patients with ulcerative colitis 
may be caused by the activity of the 
colitis. An interesting example of this 
kind of relationship is pancreatic car- 
cinoma, in which a significant propor- 
tion of patients show depression before 
any physical manifestations of the 
carcinoma are obvious. 

Perhaps related to this group of 
patients with underlying structural 
disease are those who continue to have 
problems following surgery, such as 
gastrectomy or colectomy with ileosto- 
my. Some post-gastrectomy patients 
complain of weakness, fatigue, and 
abdominal discomfort following eating. 
There is some evidence that these symp- 
toms may be more related to psycho- 
logic maladjustments than to any in- 
trinsic defect in the surgical procedure. 
A careful appraisal of the patient's 
total Hfe situation, his expectations from 



the operation, and the real cause of his 
symptoms is necessary if optimal results 
are to be gained from surgery. 

Many patients with the so-called 
post-cholecystectomy syndrome com- 
plain of abdominal pain, dyspepsia, and 
nausea, which continue after removal 
of the gall bladder. Often these patients 
have a functional illness with the chole- 
lithiasis being incidental, so removal 
of the gall bladder is ineffective in 
controlling the symptoms. 

Complete colectomy with construc- 
tion of an ileostomy presents the pa- 
tient with a major adjustment, and 
certainly some of the ileostomy prob- 
lems relate to his psychological rejec- 
tion of the stoma. In general, the more 
the patient's life has been disrupted 
by illness, diarrhea, or incontinence 
before colectomy, the more likely he 
will adjust to ileostomy life. Again, 
preoperative explanation and educa- 
tion may prevent many ileostomy prob- 
lems. 

Treatment 

Rational treatment depends on our 
ability to analyze and, if possible, cor- 
rect the various factors causing the 
patient's symptoms. In some psycho- 
somatic diseases such as ulcerative 
colitis, where there are major nutri- 
tional disturbances, appropriate mana- 
gement includes physical and psycho- 
logical therapy. 

Subtle or overt rejection of the pa- 
tient with functional disease by those 
caring for him is often an impediment 
to successful therapy. This rejection 
may be potentiated by the patient's 
hostility resulting from the dependency 
induced by his disease or as a more 
basic response in his life adjustment. 
On occasion one sees a distinct change 
in the attitudes of nurses and physicians 
toward a patient thought to have a 
functional problem when organic dis- 
ease is discovered. The patient is ac- 
cepted as having a "real" problem when 
his irritable colon symptoms are found 
to be due to a carcinoma of the colon. 

If we are to help the patient, we must 
see him as a whole, with his symptom 
or disease process as the result of many 
different forces exerted through physi- 
cal and psychological pathways. ^ 
THE CANADIAN NURSE 37 



Care of patients with 
G.I. diseases that have 
a psychological component 

". . . what is in us must out; otherwise we may explode at the wrong places or 
become hopelessly hemmed in by frustrations."* The "wrong places" at which 
we may explode can be the mucosal lining of the duodenum or the small bowel; 
our "hopeless frustrations" may be manifested by an irritated colon, chronic 
diarrhea, or an aversion to food. The patient who presents a gastrointestinal 
disease that relates in some way to anxiety or neurosis requires the nurse's 
skill and ingenuity. 



Gloria Mowchenko, B.S.N. 

What is within a person, that, if denied 
expression, turns into a destructive 
force and sends him to hospital, com- 
plaining of pain, discomfort, and an 
inability to meet his need for adequate 
nutrition? How can we understand this 
"stress response" in the patient, and 
how can we help him cope with this 
response? 

Stress, as described by Selye, is a 
condition that reveals itself by meas- 
urable changes in the organs of the 
body.^ In conditions affecting the gas- 
trointestinal tract of an individual, the 
stress response may be a manifestation 
of unhealthy ways of relating to other 
persons or of reacting to situations. 
For example, the person with a peptic 
ulcer has been described as meticulous, 
perfectionistic, ambitious, and driving. 
He may be unable to resolve the con- 
flict between what he wants to do 
and what he can do, and contains the 
frustration and resentment resulting 



Miss Mowchenko obtained her B.S.N, 
degree from the University of Saskat- 
chewan School of Nursing, where she Is 
a lecturer in fundamentals of nursing. 

* Hans Selye, The Stress of Life, New 
York, McGraw-Hill. 1956, p. 269. 



38 THE CANADIAN NURSE 



from this conflict within his growing 
"pot of hostility." 

The individual who develops ulcer- 
ative colitis may be dependent, con- 
trolled, sensitive, and fastidious. He 
may be unable to be aggressive and 
angry, translating these emotions in- 
stead into diarrhea. Indeed, he may 
succeed so well in hiding the anger 
and frustration he feels, that he con- 
vinces himself his condition is due to 
physical causes only. He may discuss 
freely the frequency of his bowel move- 
ments, the relative merits of his medi- 
cations, or his special bland diet, but 
not give vent to feelings he has long 
suppressed. 

The challenge 

Here, then, is the challenge to the 
nurse who cares for these patients: 
to help them identify and accept their 
feelings and to encourage their expres- 
sion. 

The nurse's approach is based on 
the concept that all behavior is mean- 
ingful to the individual expressing it. 
If she realizes the individual is the sum 
total of all his experiences and that he 
reacts to stressful situations in ways 
that lessen unbearable anxiety, she 
will understand that the diarrhea of 
ulcerative colitis may represent a sit- 

MARCH 1971 




MARCH 1971 



uation where anger was felt, but the 
patient could not become angry. 

During hospitalization, the patient 
needs to feel safe from the stresses 
that may have precipitated his illness. 
Although his demands for attention 
and his dependency may tax the nurse's 
patience, she should be protective and 
gentle in her ministrations to him. 
When trust has been gained, she can 
help him identify, explore, and accept 
some of his feelings. He may not be 
able to settle his conflict, but he may 
learn to turn the anger to the outside 
where it can dissipate, rather than keep 
it inside where it can destroy. 

Along with the nurse's expressive 
functions goes the important task of 
administering the patient's medical or 
surgical regimen. His cooperation is 
essential, and depends on his under- 
standing of the treatment and its im- 
portance. Sometimes the nurse and 
other members of the health team are 
thwarted in their attempts to help the 
patient get better, as he may reject the 
treatment program, apparently denying 
the fact of his illness. This patient poses 
an extra challenge to those giving him 
care, as they have to deal first with 
their own anger and frustrations, caus- 
ed by their inability to help. 

Just being sick 

The physical aspects of caring for 
the patient with a gastrointestinal 
disease associated with anxiety or neu- 
rosis include: planning for nutritious 
food and fluid intake; general and 
specific measures for hygiene; and 
those activities that relieve pain and 
promote comfort for the patient plagued 
by cramps, tenesmus, and weakness. 

Of prime importance is the patient's 
need for rest, a need that Selye notes 
is present in all illnesses where the 
stress response is evident or in the 
syndrome of "just being sick."^ Rest 
is needed to allow an ulcer, a diseased 
colon, or a damaged spirit to heal. 

If surgical intervention is necessary, 
the nurse helps to create a climate in 

THE CANADIAN NURSE 39 

% 



which the patient can clarify his under- 
standing of the procedures. He and his 
family may require specific informa- 
tion and instruction about habits of 
elimination, skin care, and the use of 
appliances, such as colostomy or ileos- 
tomy bags. 

The story of Lynn 

Share with me the story of Lynn, 
a 15-year-old, deaf since birth, who 
had developed a clinging dependency 
on an oversolicitous mother, an inabili- 
ty to function socially with her peers, 
and an intractable case of ulcerative 
colitis. That her colitis related to her 
unhealthy patterns of reacting to stress- 
ful situations was evident during hos- 
pitalization: her relatively quiescent 
bowel would become inflamed and dis- 
charge frequent, loose, bloody stools 
when her mother visited and encourag- 
ed her child's dependency on her. 

To help this child, we tried to create 
a consistent approach by the nursing 
staff: patiently, Lynn's nurses treated 
her with firmness, gentleness, and kind- 
ness. She was encouraged to help carry 
out her own care and keep her room 
neat. 

Slow improvement was noted, which 
was sufficient to warrant Lynn's dis- 
charge from hospital after several weeks. 
She was readmitted a few days later, 
however, with severe rectal hemorrhag- 
ing. An abdominal-perineal resection 
and ileostomy were performed as life- 
saving measures. 

What conflicts were there in this 
mother-daughter relationship and in 
other relationships in the home to pre- 
cipitate such severe symptoms in Lynn? 
What feelings was she unable to 
express and transferred, instead, into 
organic changes'.' What part did her 
deafness play in her total adjustment 
to growing up and to life? Here we 
can guess, perhaps with some accuracy, 
the relationships between the mind and 
body components of Lynn's disease; 
but these remain guesses, not proven 
facts. As mentioned, the causal relation- 
40 THE CANADIAN NURSE 



ship between the emotional upset and 
the disease state has not been clarified 
in the classical case of ulcerative colitis. 

Following surgery, Lynn required a 
great deal of her nurse's time, patience, 
and tact in dealing with all aspects of 
care. She transferred her dependency 
from her mother to her nurse and be- 
came reluctant to move, sit up, or take 
fluids without the nurse's sustaining 
presence at her side. She wept at the 
merest disturbance in her room, at 
every adjustment made in her intrave- 
nous infusion, every blood pressure 
check, every suggestion that she move 
her legs or change position. 

Again, through a patient, consistent 
approach, Lynn developed trust in her 
nurses and was able to tolerate even the 
dressing changes with equanimity. She 
gradually replaced some of her tears 
with smiles, and began to ask hesitant 
questions concerning her incisions. 

It was evident that little concrete 
progress could be made toward the 
goal of having this patient identify 
and verbalize strong negative feelings 
until her physical condition became 
less of a primary concern. Certainly 
the establishment of a protective, 
accepting atmosphere was helpful in 
calming some of her more overt fears. 
The nurses who cared for her believed 
they had gained her trust and that she 
had matured somewhat during her 
hospital stay. 

Throughout both of Lynn's hospital- 
ization periods, attempts were made 
to involve family members in her care. 
A surprising ally was discovered in her 
younger sister, who seemed to possess 
the maturity that Lynn lacked. She was 
the one who was able to reassure Lynn, 
calmly and in a matter-of-fact tone, 
and help her comply with the treatment 
program. Projected plans for follow- 
up care in the home involved this sister 
because she showed a desire and an 
inclination to help. However, we con- 
tinued to attempt to improve the re- 
lationship between Lynn and her mo- 
ther, as we believed she could prove 



to be the most significant figure in 
Lynn's total adjustment to her illness. 

Another guide 

Perhaps Selye's concepts of stress 
can provide us with yet another guide- 
line as we strive to understand the mind- 
body relationships in gastrointestinal 
disease. If man's ultimate aim is to 
express himself as fully as possible, 
according to his own lights; and if the 
goal is certainly not to avoid stress as 
stress is part of life, then to express 
himself fully, he must first find his 
optimum stress level, and then use his 
adaptation energy at a rate and in a 
direction adjusted to the innate struc- 
ture of his mind and body. ^ 

Can we help our patients express 
themselves as fully as possible? Can 
we help them find the best way to use 
their adaptation energy? Can we, 
and will we, let them grow? If we are 
to help the patient with a gastrointes- 
tinal disease that has a psychological 
component, our answers to these 
questions must be in the affirmative. 

References 

l.Selye, Hans. The Stress of Life. New 
York, McGraw-Hill, 1956, p. 54. 

2. Ibid., p. 26. 

3. Ibid., pp. 299-300. 

Bibliography 

Beland, Irene L. Clinical Nursing: Patho- 
physiological and Psychosocial Ap- 
proaches 2ed. London, Ont., Collier- 
Macmillan, 1970, pp. 497-528. 

DeLuca, Jeanne C. The ulcerative colitis 
personality. Nursing Clinics of North 
America. 5:1:23-33. March 1970. 

Gregg, Dorothy. Reassurance. In Skipper, 
James K. and Leonard, Robert C, So- 
cial Interaction and Patient Care. 
Philadelphia, Lippincott, 1965, pp. 
127-136. -§> 



MARCH 1971 



idea 
exchange 



Library service widens horizons for "shut-ins" 



Librarians wiio make house calls? In 
Toronto, you'll find them — as part 
of a special service offered by the 
Toronto Public Libraries. 

This type of service is especially 
designed for those who are too old 
to go out or for those who are not ill 
enough to be confined to hospital, yet 
not well enough to leave their homes. 
Many of these people live alone, and 
for them the days can be endless. 
Although friends and neighbors may 
come to visit or to bring necessities 
such as groceries and medicines, it 
may be difficult to ask them for more 
service — to bring books from the 
library. This may seem an unnecessary 
imposition. 

Since September 1970, there has 
been no problem for shut-ins to get 
reading material. The shut-in service 
operated by the Travelling Branch of 
the Toronto Public Libraries provides 
a regular delivery service every three 
weeks for those who cannot go to the 
library themselves. Margaret Garstang 
and Jack McGinnis visit homes from 
Monday to Friday, and after only a 
few months of traveling can count more 
than 100 persons among their regular 
borrowers of books. The number is 
constantly growing, and the station 
wagon that serves as a delivery van 
may soon be too small. 

The service is free to any resident 
of the City of Toronto who has been 
confined to his home for three months 
or more because of age or illness. As 
in a library branch, any reasonable 
number of books may be borrowed for 
the three-week period. Fiction, non- 
fiction, foreign-language books, and 
books in large print are most sought 
after. 

Individuals may telephone to request 
service, but referrals from doctors, 
nurses, social workers, clergy, friends, 

Mrs. Millen is publicity and public rela- 
tions officer of the Toronto Public Li- 
brary, 40 St. Clair Ave. East. Toronto 
290. Ontario. 

MARCH 1971 



Vivian Millen, B.A., B.|. 

or relatives are welcomed by the li- 
brary. Doctors, nurses, and visiting 
nursing associations have been of 
particular help in making referrals and 
have commented on the value of this 
service. 

Borrowers of books are of any age 
from 20 to 90 years; live anywhere 
from the expensive residences of Rose- 
dale and Forest Hill to the low rent 
apartment blocks of Moss Park and 
Regent Park; and read anything from 
history and philosophy to mystery and 
westerns. 

The librarian's visit often seems 
just as important as the books borrow- 
ed. The personal attention, the time 
and care in selecting books to suit the 
reading tastes of each individual are 
rewarded by the warm "Hello, come 
in," when the next visit is made. Without 
doubt, the shut-ins are among the most 
appreciative of any borrowers to whom 
the Toronto Public Libraries provide 
service. 




Jack McGinnis of the Toronto Public 
Libraries "Shut-In" Service staff sorts 
books for residents of an Ontario Hous- 
ing Project in downtown Toronto. 




Robert Lefevre, a frequent borrower, browses through the selection of books 
brought for him . ^ 

THE CANADIAN NURSE 41 



Auditors' Report 



CANADIAN NURSES' ASSOCIATION 
BALANCE SHEET 

as at December 31, 1970 
(with comparable figures at December 31, 1969) 

ASSETS 

Current Assets 1970 1969 

Cash in bank — current account $ 32,480 $ 17,398 

— savings account — 5V2% 186,705 223,904 

— short term deposits plus accrued interest 104,060 203,020 

Accounts receivable 32,760 20,784 

Membership fees receivable 141,932 33,260 

Prepaid expenses 9,398 10,118 



Sundry Assets 

Marketable securities — at cost 

(Quoted value $10,981; 1969 — $12,205) 
Loans to member nurses 



Fixed Assets 

C.N.A. House — land and building — at cost less 

accumulated depreciation on building 647,401 

Furniture and fixtures — at nominal value 



507,335 


508,484 


3,779 
18,465 


3,779 
17,565 


22,244 


21,344 


647,401 
1 


679,268 
1 


647,402 


679,269 


1,176,981 


1,209,097 



Approved by the Board: 

MISS E. LOUISE MINER President 

DR. HELEN K. MUSSALLEM Executive Director 



42 THE CANADIAN NURSE MARCH 1971 



Auditors' Report 



CANADIAN NURSES' ASSOCIATION 
BALANCE SHEET 

as at December 31, 1970 
(with comparable figures at December 31, 1969) 

LIABILITIES 

Current Liabilities 1970 1969 

Accounts payable and accrued liabilities $ 36,448 $ 97,443 

Unearned subscription revenues 24,900 24,750 



Mortgage Payable — 6 V4% due 1976 — repayable in blended monthly instalments of 
$3,548 including principal and interest 



Surplus 



61,348 


122,193 


413,479 


428,001 


702,154 


658,903 


1,176,981 


1,209,097 



We have examined the balance sheet of the Canadian Nurses' Association 
as at December 31, 1970 and statement of income and surplus for the year then 
ended. Our examination included a general review of the accounting procedures 
and such tests of accounting records and other supporting evidence as we 
considered necessary in the circumstances. 

In our opinion, these financial statements present fairly the financial position 
of the association as at December 31, 1970 and the results of its operations for 
the year then ended, in accordance with generally accepted accounting principles 
applied on a basis consistent with that of the preceding year. 



GEO. A. WELCH & COMPANY, 
CHARTERED ACCOUNTANTS. 
Feb. 8, 1971. 



MARCH 1971 THE CA^IADIAN NURSE 43 



CANADIAN NURSES' ASSOCIATION 
STATEMENT OF REVENUE AND EXPENDITURE AND SURPLUS 

for year ended December 31, 1970 
(with comparative figures for year ended December 31, 1969) 



Revenue: 

Membership fees $ 

Subscriptions 

Advertising 

Sundry revenue 



Expenditure: 

Operating expenses: 

Salaries 

Printing and publications 

Postage on journal 

Building services 

Staff travel 

Committee meetings 

I.C.N, affiliation 

Commission on advertising sales 

Computer service 

Office expense 

Legal and audit 

Translation services 

Consultant fees 

Sundry 

Production of film 

Furniture and fixtures 

Landscaping and improvements 
Depreciation — C.N.A. House 



Non-operatii^ expenses: 

C.N.A. Testing Service — per statement 

1970 Biennial convention 

LC.N. Seminar 

Canadian Nurses' Foundation 

Commonwealth Foundation Fund 



1970 


1969 


768,914 


$ 697,754 


36,137 


30,903 


217,508 


249,194 


10,102 


13,249 



1,032,661 


991,100 


384,473 


384,534 


208,972 


216,511 


113,416 


79,304 


73,752 


72,930 


9,391 


9,684 


22,976 


28,582 


32,567 


31,214 


17,225 


18,261 


18,397 


30,775 


21,428 


25,559 


3,120 


4,750 


935 


2,533 


11,494 


9,322 


5,112 


938 


13,373 


— 


3,780 


4,826 


1,736 


16,157 


31,867 


31,867 


974,014 


967,747 


67,492 




12,276 


145 


899 


— 


5,940 


3,131 


529 


— 


87,136 


3,276 


1,061,150 


971,023 



Excess of revenue over expenditure (expenditure over revenue) 

before investment income (28,489) 20,077 

Investment income 27,946 25,126 

Excess of revenue over expenditure (expenditure over revenue) 

for year ( 543) 45,203 

Surplus at beginning of year 658,903 482,737 

I.C.N. Congress: 

Transfer from reserve account 130,963 

Grant from Quebec Provincial Government 25,000 ' — 

Credit on settlement of Congress accounts 18,794 — 

Surplus at end of year $ 702,154 $ 658,903 



44 THE CANADIAN NURSE 



MARCH 1971 



CANADIAN NURSES' ASSOCIATION 

STATEMENT OF REVENUE AND EXPENDITURE 

C.N.A. TESTING SERVICE 

for year ended December 31, 1970 

Revenue: 

Examination fees $ 127,264 



Expenditure: 

Salaries 37,119 

Travel and committee meetings — general 23*043 

— item writing 9,839 

Payment to R.N.A.O. for testing service 60,000 

Operations (data processing, printing, warehousing) 16^359 

System design and programming 19^133 

Rent ; 5^644 

Office expenses 5 739 

Furniture and fixtures 15^792 

Sundry 2^088 



194,756 



Excess of expenditure over revenue for year $ 67,492 



MARCH 1971 THE CANADIAN NURSE 45 

% 



The 

Canadian 
Nurse 

50 The Driveway, Ottawa 4, Canada 




Information for Authors 



Manuscripts 



The Canadian Nurse and L'infirmiere canadienne welcome 
original manuscripts that pertain to nursing, nurses, or 
related subjects. 

All solicited and unsolicited manuscripts are reviewed 
by the editorial staff before being accepted for publication. 
Criteria for selection include : originality; value of informa- 
tion to readers; and presentation. A manuscript accepted 
for publication in The Canadian Nurse is not necessarily 
accepted for publication in L'infirmiere Canadienne. 

The editors reserve the right to edit a manuscript that 
has been accepted for publication. Edited copy will be 
submitted to the author for approval prior to publication. 

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Articles 

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Style and Format 

Manuscript length should be from 1 ,000 to 2,500 words. 
Insert short, descriptive titles to indicate divisions in the 
article. When drugs are mentioned, include generic and trade 
names. A biographical sketch of the author should accompa- 
ny the article. Webster's 3rd International Dictionary and 
Webster's 7th College Dictionary are used as spelling 
references. 

References, Footnotes, and 
Bibliography 

References, footnotes, and bibliography should be limited 
46 THE CANADIAN NURSE 



to a reasonable number as determined by the content of the 
article. References to published sources should be numbered 
consecutively in the manuscript and listed at the end of the 
article. Information that cannot be presented in formal 
reference style should be worked into the text or referred to 
as a footnote. 

Bibliography listings should be unnumbered and placed 
in alphabetical order. Space sometimes prohibits publishing 
bibliography, especially a long one. In this event, a note is 
added at the end of the article stating the bibliography is 
available on request to the editor. 

For book references, list the author's full name, book 
title and edition, place of publication, publisher, year of 
publication, and pages consulted. For magazine references, 
list the author's full name, title of the article, title of mag- 
azine, volume, month, year, and pages consulted. 

Photographs, Illustrations, Tables, 
and Charts 

Photographs add mterest to an article. Black and white 
glossy prints are welcome. The size of the photographs is 
unimportant, provided the details are clear. Each photo 
should be accompagnied by a full description, including 
identification of persons. The consent of persons photo- 
graphed must be secured. Your own organization's form 
may be used or CNA forms are available on request. 

Line drawings can be submitted in rough. If suitable, they 
will be redrawn by the journal's artist. 

Tables and charts should be referred to in the text, but 
should be self-explanatory. Figures on charts and tables 
should be typed within pencil-ruled columns. 

The Canadian Nurse 

OFFICIAL JOURNAL OF THE CANADIAN NLIRSES" ASSOCIATION 

MARCH 1971 



Occult hydrocephalus 
in adults 

The authors describe the care of patients who have a type of hydrocephalus in 
which distension of the cerebral ventricles has occurred after union of the 
cranial sutures. As a result these patients do not have enlargement of the 
head. They generally show some degree of mental deterioration, gait 
disturbance, and incontinence. 



In most cases of hydrocephalus, the 
cerebrospinal fluid pressure is elevated. 
Only in the last several years have 
cases of hydrocephalus been described 
in which the CSF pressure has never 
risen above 180 mm. — the figure 
usually considered to be at the upper 
limits of normal.^ 

An explanation for hydrocephalus 
with normal CSF pressure has been 
postulated as follows: The pressure 
within the ventricles probably is high 
in the initial stages of the disease; this 
raised pressure causes the ventricles to 
enlarge and the brain tissue around the 
ventricles to yield gently. Once enlarged, 
the ventricles are maintained in this 
state by CSF pressures lower than those 
that caused the initial enlargement. 
The system reaches an equilibrium 
because the more the ventricles dilate, 
the more CSF they absorb.^ 

The symptoms of low-pressure hy- 
drocephalus vary from patient to pa- 
tient, but most seem to have one or 
more of the following symptoms: 

1 . Mental deterioration of some degree. 
This is the principal manifestation and 
the reason that many patients were 
formerly diagnosed as having pre- 
senile dementia. The patient may lack 
interest and initiative, have a short 
attention span, be apathetic and slow 
in thought and action. 

2. Gait disturbance. 

3. Bladder and bowel incontinence. 
In almost all cases, headache is either 

absent or negligible. 
MARCH 1971 



Carol Schick, R.N. 

and Elizabeth Yallowega, R.N., B.A. 

Symptoms may develop over a period 
of weeks to months. Because of the 
relatively insidious progress of this 
disease, the signs vary with the dura- 
tion of the illness. 

Preoperative nursing care 

As with all neurosurgical admis- 
sions, the nurse bases her plan of care 
on her observations of the patient's 
signs and symptoms. 
Physical care includes: 

Intake: The patient may show lack 
of interest in eating, and have difficul- 
ty selecting what and when he should 
eat. The nurse and dietitian can help 
him with this problem. Hydration may 
be a problem, and oral intake is pre- 
ferred. 

Elimination: There is usually some 
degree of incontinence. The nurse tries 



Miss Schick, a graduate of the Winnipeg 
General Hospital, is presently Head Nurse 
in Neurology and Neurosurgery at the 
Winnipeg General Hospital. Miss Yallo- 
wega, a graduate of the Winnipeg General 
Hospital, is presently Administrative 
Assistant, Intensive Care Nursing Serv- 
ices, at the same hospital. This article 
was adapted from a paper presented in 
Toronto at the June 1970 meeting of the 
Canadian Association of Neurological 
and Neurosurgical Nurses. The authors 
acknowledge the assistance in research 
they received from the neurosurgeons 
and residents at the Winnipeg General. 



to establish a regimen for the patient 
by assisting him to the bathroom at 
regular intervals. Some patients require 
an indwelling catheter and bowel dis- 
impaction. 

Skin Care: Tub baths are preferable 
to any other method of cleaning the 
skin; frequent turning and skin care 
is essential. 

Ambulation: The patient may need 
help to get in and out of bed, and the 
signal cord should be pinned to his 
gown. Side rails help to prevent him 
from falling out of bed. 

Sleep: Sedation is not usually nec- 
essary, as these patients tend to be 
drowsy and apathetic. Also, a sedative 
usually is contraindicated as it inter- 
feres with assessment of the patient's 
level of consciousness and with diag- 
nostic testing. 

The psychological care is based 
primarily on the patient's need for 
independence and feelings of self- 
worth. Often he has become overly 
dependent on others for basic require- 
ments. Because of his marked demen- 
tia, he is often rejected by his family 
and alienated from group involvement. 
He needs to be accepted on the ward 
and treated as an individual. 

Members of the patient's family are 
upset because they cannot understand 
what has caused this change in his 
behavior. The nurse must be alert to 
their needs and be available to allow 
them to voice their concerns; at the 
same time, she must protect the patient 
THE CANADIAN NURSE 47 



from becoming involved in this conflict 
of feelings. 

While the patient is undergoing 
diagnostic testing, the nurse explains 
the tests to him, whether or not she 
believes he understands her explana- 
tions. Sometimes repetition is nec- 
essary. Not only is explanation re- 
quired, but also continued vigilance 
on the part of the nursing staff to have 
the patient remain flat, not eat, drink, 
and so on, before and after the tests. 

The tests (angiogram, pneumoen- 
cephalogram, electroencephalogram, 
echoencephalogram, Risa Scan) may 
or may not involve anesthetics. In 
several instances it has been found 
that patients deteriorate following diag- 
nostic procedures, mainly after pneu- 
moencephalography. 

Once the patient has been diagnosed, 
preparations for surgery are made. 
Usually the morale of both staff and 
family improves at this point. 

The physiotherapy department may 
be consulted if the patient needs deep 
breathing exercises. If he smokes, he 
is advised to stop several days before 
an anesthetic is given. 

The patient's head is completely 
shaved the evening before surgery. The 
nurse explains this procedure to the 
patient and the family as it may be 
upsetting, particularly to female pa- 
tients. 

Treatment and postoperative care 

Low pressure hydrocephalus is treat- 
ed by inserting a ventriculo-atrial shunt, 
utilizing a low pressure valve (usually 
the Pudenz valve) to drain off the CSF. 
The pump is positioned behind and 
above the right ear, with the proximal 
end passing through a burr hole in the 
skull and through the cerebral mantle 
to lie within the right lateral ventricle 
of the brain. 

The distal end of the shunt passes 
downwards, subcutaneously behind 
the ear, to reach the neck where it is 
threaded into the common facial vein 
and down into the superior vena cava 
and right atrium. Thus, the subara- 
chnoid space block is bypassed by 
shunting the fluid from the ventricles 
of the brain to the right atrium of the 
heart. The correct placement within 
the atrium or lower superior vena cava 
is determined by a chest x-ray at the 
time of surgery. 

Postoperative care of the patient is 
mainly one of observation. Vital signs 
are checked and the patient's level of 
consciousness is assessed carefully. 
Occasional flushing of the shunt, by 
48 THE CANADIAN NURSE 



pressing the skin covering the pump, 
is necessary to maintain patency. 

Complications, which the nurse tries 
to prevent, are: 

• Wound Infection: These patients 
invariably pick at their dressing and 
wound postoperatively. 

• Chest Infection: Early ambula- 
tion and frequent turning and position- 
ing will help prevent this. Fluids must 
be forced, but at the same time the 
level of consciousness must be ob- 
served carefully because of the hazard 
of aspiration pneumonia. 

• Urinary Tract Infection: This may 
occur if the patient has had an in- 
dwelling catheter or repeated catheter- 
ization. 

• Phlebitis: This is a hazard, par- 
ticularly if the patient has not been 
ambulant preoperatively. Exercising 
and elevating the lower extremities 
is an important aspect of f)ostoper- 
ative care. 

Early ambulation, continuous ob- 
servation, and stimulation are bene- 
ficial to the patient both physically and 
psychologically. Independence is en- 
couraged. Teaching him to care for 
himself and to pump his own shunt 
depend on the results of the surgical 
intervention. Sometimes these results 
are dramatic: the patient wakes up. 



stops soiling himself, has improvement 
in his mental state, and becomes a 
useful citizen again. 

Patient histories 

Mrs. B., a 51 -year-old, obese dia- 
betic was admitted to the Winnipeg 
General Hospital on July 11, 1969, 
because of weakness of the legs and 
mental confusion. On admission she 
was incontinent of urine, appeared dull, 
but was able to obey simple commands. 
While in hospital her condition dete- 
riorated: she became drowsy, more 
confused, and had marked ataxia, 
falling to the right. A left facial weak- 
ness and a left hemiparesis were also 
noted. When she was transferred to the 
neurosurgical ward she had a Foley 
catheter in place, was unable to bear 
weight, smiled inappropriately, and 
talked only in monosyllables. 

Mrs. B's differential diagnosis was 
frontal lobe tumor, senile deteriora- 
tion, arteriosclerosis, or hydrocepha- 
lus. Her skull x-rays were normal, 
and she was found to be slightly hyper- 
tensive, a blood pressure of 140/95. 

A right carotid angiogram was done 
July 30, showing a wide sweep of the 
anterior cerebral arteries. (Figure 1 .) 
A pneumoencephalogram, done two 



Figure I . Carotid angiogram showing sweep of anterior cerebral artery. 




MARCH 1971 



days later, showed greatly dilated 
lateral ventricles with no air spread 
over the convexity of the hemispheres. 
(Figure 2.) 

On August 15, a Pudenz valve was 
inserted. By August 18 Mrs. B. was 
more spontaneous, her level of cons- 
ciousness seemed elevated, and she was 
able to feed herself. Four days later she 
was able to go the bathroom unassisted. 

She was discharged on August 26, 
able to look after her basic needs, but 
without having mastered the care of her 
shunt. 

On December 2, 1969, four months 
after her first admission, Mrs. B. was 
readmitted to hospital. When she re- 
turned for a check-up, the doctor found 
the shunt to be working poorly and 
suspected a partial shunt block. 

The shunt was revised on December 
8. Apparently the proximal end of the 
shunt was blocked because the ventricle 
had contracted down so far that the 
walls of the ventricle were against the 
intake end of the mechanism. The dis- 
tal end was emptying perfectly. At 
surgery, the proximal end was shorten- 
ed and reconnected. 

A follow-up was done on December 
12. 1969. This showed the ventricular 
size to be greatly reduced since the 
pneumoencephalogram had been done 
four months earlier. (Figure 3.) 

Mrs. W., a 68-year-old patient, was 
admitted to hospital October 20, 1969, 
with a two- to three-year history of 
falls because "her legs wouldn't hold 
her." She used a cane to get about. 

On examination she was alert, happy, 
oriented to name and place but not to 
time, and slow to answer questions. 
She had difficulty with memory and 
calculation. For the past few months 
she had experienced urgency with 
both urine and feces, and was inconti- 
nent during the examination. Her left 
hand and arm coordination was poor, 
and power in both legs was diminished. 
She walked on a broad base with short 
halting steps. 

X-rays of this patient's skull and 
cervical spines were normal, except 
for some spinal degeneration at the 
level of C5, 6, and 7. An echoence- 
phalogram showed no shift of midline 
structures, but did demonstrate enlarge- 
ment of the ventricles. The 3rd ventri- 
cle measured 24 mm. (normal 10 mm.); 
the right lateral ventricle, 34 mm. 
(normal 20 mm.); and the left lateral 
ventricle. 46 mm. (normal 20 mm.). 

A pneumoencephalogram showed 
dilated lateral and 3rd ventricles. The 
MARCH 1971 




Figure 2. A pneumoencephalogram done before surgery shows vastly dilated 
lateral ventricles. 



Figure 3. Follow-up show;: 
pneumoencephalogram . 



ventricular size greatly reduced since the earlier 




THE 



CAN^ 



DIAN NURSE 49 




Figure 4. The Pudenz valve being in.scnca during surgery. 



pneumogram was repeated with up- 
right views, which showed moderate 
enlargement of the 4th ventricle aque- 
duct. 

On November 3, a Pudenz valve was 
inserted (Figure 4). 

Postoperatively, Mrs. W.'s vital 
signs remained stable, but within 48 
hours she complained of vertigo and 
nausea on leaning to the right. This 
was presumed to be a brain stem in- 
farct. These symptoms disappeared 
within 24 hours and she was discharg- 
ed November 19, 1969, with follow- 
up by Home Care. 

We requested a report from Home 
Care and received the following: 

"I visited the above lady every two 
days for the first two weeks after her 
discharge, until I was certain she was 
carrying out instructions regarding the 
Pudenz valve. Mr. W. has been carry- 
ing out the procedure since her dis- 
charge, and to make it easier for them 
to locate the pump 1 have clipped the 
hair immediately over it. 

"Mrs. W. has not, to date, assumed 
this responsibility. I am not sure she 
feels she can do a good job as she has 
difficulty finding the spot and apply- 
ing the necessary pressure. 

"Mrs. W. walks with one cane and 
usually forgets where she has put it 
She does her own cooking; however, 
someone must do the heavy housework. 
50 THE CANADIAN NURS£ 



She and her husband usually go down- 
town one afternoon a week to shop. 
They do not seem to have too many 
visitors, nor do they join in community 
activities. 

"1 visit this couple monthly, and I 
must be prepared to stay the minimum 
of one hour. Mrs. W. seems to dwell in 
the past and I have each time attempted 
to encourage her to become more inde- 
pendent. I feel she and her husband 
are doing exceptionally well." 

References 

I.Adams, R.D., Fisher, CM., et at. 
Symptomatic occult hydrocephalus 
with "normar" cerebrospinal fluid 
pressure: treatable syndrome. New Eng. 
J. Mw/. 273:3:121, July 15, 1965. 

2. Hakim, S. and Adams. R.D. The spe- 
cial clinical problem of symptomatic 
hydrocephalus with normal cerebro- 
spinal fluid pressure. J. Neiirolog. 
Science 2-301 , 1965. 

Bibliography 

Adams, et at. Symptomatic occult hy- 
drocephalus with normal C.S.F. pres- 
sure, NEJM 273: 1 17-26, 1965. 

Baska. R.E. ei iil. Symptomatic occult 
hydrocephalus — a case report and 
review. Soitiliern Medicid Journal 
61:242, March 1968. 

Diagnosis of normal pressure hydrocepha- 
lus by RHISA cysternography. J. Nu- 



clear Medicine 9:457-61, August 
1968. 

Gschwind, N. The mechanism of normal 
pressure hydrocephalus. J. Ncurolog. 
Science 7:481:93, November-Decem- 
ber 1968. 

Hakim, S. and Adams, R.D. The special 
clinical problems of symptomatic hy- 
drocephalus with normal CSF pres- 
sure. J. Neurolog. Science 2:307-27, 
1965. 

Messert. B.. and Baker, N.H. Syndrome 
of progressive spasticataxia and apra- 
xia associated with occult hydroce- 
phalus. Neurology 16:440-52. 1966. 

Messert, B., Henke, T.K. and Longheim, 
W. Syndrome of akinetic mutism asso- 
ciated with obstructive hydrocepha- 
lus. Neurology 16:635-49, 1966. 

Moore, M.T. Progressive akinetic mutism 
in cerebellar hemangioblastoma with 
normal pressure hydrocephalus. Neu- 
rology. 19:32-6, January 1969. 

McDonald. J.V. Persistent hydrocephalus 
following the removal of papilloma of 
the choroid plexus of the lateral ven- 
tricle — report of two cases. J. Neuro- 
™r^. 30:736. June 1969. 

Isotope cisternography in hydrocephalus 
with normal pressure — case report — 
technical note. J. Neurosurg. 29:555- 
61, November 1968. ^ 



MARCH 1971 



Pinsent, Amelia. A study of mother- 
nurse interaction during feeding 
time when the mother is feeding 
her baby. Montreal, 1970. Thesis 
(M.Sc. (App.) McGill University. 

The purposes of this study were to 
determine the main concerns of the 
nurse and the new mother during feed- 
ing time when the mother is feeding 
her baby; the assistance given by the 
nurse to the mother who needs help in 
feeding her baby; and some of the 
factors that influence the nurse's activity 
in assisting the mother in feeding her 
baby. 

Thirty-two English-speaking mar- 
ried women who were bottle feeding 
their babies comprised the sample of 
mothers, all of whom had semi-private 
accommodation. The sample of nurses 
was made up of six graduate nurses 
and three nursing assistants. 

Data were collected during 48 ob- 
servations of mothers while feeding 
their babies. A total of 124 mother- 
nurse interactions were recorded dur- 
ing the feeding time. 

A content analysis of the mother- 
nurse interactions revealed that the 
nurse and the mother had different 
concerns in feeding the baby. The 
nurse's main concern was to have the 
baby take the desired amount of for- 
mula during the feeding time, and her 
activities were directed toward this 
goal. The mother's main concerns were 
with the condition of the baby and 
with her own ability to feed him, man- 
ifested by seeking information regard- 
ing the baby's condition and by evaluat- 
ing her own ability to feed him. 

Assistance given to the mother by 
the nurse was directed toward her goal 
of having the baby take the desired 
amount of formula. The mother ac- 
knowledged the concern of the nurse 
regarding the amount of formula the 
baby was expected to take, or had taken 
during the feeding, by stating the 
amount when the nurse approached her 
or by answering the nurse's question 
regarding the feeding. The mother 
added her concerns once she had given 
the information sought by the nurse. 

The nurse acknowledged the state- 
ment of amount, but gave varied re- 
sponses to statements of the mother's 
concerns. She answered the mother's 
questions or statements of concerns 
by suggesting how the baby's intake 
could be increased and by giving the 

MARCH 1971 



reasons why the stated amount was 
desirable; by changing the subject 
to that of facilitating the present and/or 
future feedings; by feeding and/or 
burping the baby herself; by stating 
that she did not know the answer to 
the question asked; or by completely 
ignoring the mother's question or state- 
ment. 

The environment in which the nurse 
functioned was conducive to providing 
physical care for the mother and baby. 
The unit was divided into three sec- 
tions, each with a separate nursing 
staff. Within the nursery, feeding sched- 
ules were at times when only some of 
the staff were available to assist moth- 
ers. This meant that three different 
nurses could have contact with a moth- 
er during the three phases of feeding, 
so that a nurse who had helped the 
mother during one phase of the feeding 
could miss the opportunity to evaluate 
the immediate results of assistance 
given to the mother. 

Two questions arising from this 
study are: 

1 . What does the nurse understand her 
role to be in maternity nursing? Is she 
ready or willing to assist mothers with 
their problems? 

2. When the organization of the unit 
and the staff is strongly delineated 
and specialized, who solves the prob- 
lems regarding the baby's condition 
which, in turn, can create difficulties 
sufficient to interfere with the mother's 
healthy recovery? 

Munro, Margaret F. A study of liter- 
ature selection in baccalaureate 
students in nursing. Minneapolis, 
Minn., 1967. Research study (M.Ed.) 
U. of Minnesota. 

This study was seen as a pilot project 
to investigate the frequency and reason 
for reading a selected variety of books 
as demonstrated by students in a bac- 
calaureate program in nursing. The 
writer was particularly interested in 
the correlation between use of specific 
types of literature and (a) the philos- 
ophy underlying the school's curric- 
ulum, (b) the level of nursing educa- 
tion and experience of the individual 
student, and (c) the concept of what 
constitutes "educational" literature. 

An instrument was developed con- 
taining 133 publications. These, con- 
sidered by the investigator to be of 
current value to nurses, were selected 



from the literature specific to nursing, 
from related sciences, or from bio- 
graphical works focused on problems 
of health. The items were arranged 
alphabetically within a system of the 
eight following categories: general 
references; communications; commu- 
nity health and welfare; neuropsychia- 
tric studies; pediatric studies; maternity 
and newborn studies; medical-surgical 
studies; and psychosocio-cultural sub- 
jects. These categories were seen as 
an arbitrary method of handling the 
data and did not necessarily reflect 
publishers' classifications or curricu- 
lum design. 

Respondents were given a copy of 
this bibliography and requested to 
reply to two specific questions for 
each item: frequency of contact with 
the item, and why it was used. The 
frequency of contact was given a four- 
point scale: very often, often, seldom 
and never. The purpose of use was 
given a three-point scale: as an aid to 
current education, as an aid to current 
employment, for personal pleasure. 

All respondents were enrolled at 
the same university and were in their 
final or'next-to-final year of the bac- 
calaureate program in nursing. They 
represented students enrolled in a 
generic program and those completing 
a degree following graduation from a 
hospital program. In this school, the 
curriculum was based on broad con- 
cepts of nursing and did not reflect 
the traditional clinical areas. 

The findings indicated a positive 
correlation between the philosophy 
of the program of study and the cate- 
gories of publications most frequently 
chosen, in that publications in medical 
specialties were selected less frequently 
than those in communications or psy- 
chosocio-cultural programs. No signif- 
icant difference was found between 
students in the generic program and 
graduates from diploma programs, 
nor between levels of students. 

The findings also indicated that 
students tended to read biographical 
publications for personal interest rather 
than for value in relation to their educa- 
tion or practice of nursing. 

This study, though limited in scope, 
appears to have implications for nurs- 
ing educators in selecting bibliographic 
material for students or in directing 
students into areas of further investiga- 
tion in accordance with the philosophy 
of the educational program. § 

THE CANADIAN NURSE 51 



Psychiatric Nursing, 5ed., by Ruth V. 
Matheney and Mary Topalis. 346 
» pages. Toronto, C.V. Mosby, 1970. 
Reviewed by Peter Boyle, Instruc- 
tor, The Saskatchewan Hospital, 
Weyburn, Saskatchewan. 

The fifth edition of this book is marked 
by changes in format and content. The 
new format of larger print and marginal 
sub-headings is pleasing to the eye. 

Content has been expanded to give 
a wider, more balanced overview of 
the subject matter. 

Presentation of current theories of 
personality development and psycho- 
pathology is brief but will serve to 
direct the more serious student toward 
those constructs that are influencing 
psychiatry and psychiatric nursing. 

Unit two, the heart of this text, 
remains little changed. The principles 
of psychiatric nursing are valid for all 
patients regardless of diagnosis and 
treatment area. 

Chapter 20 (drug addiction, the 
nurse, and the community) is a pleasure 
to read. 

The authors present facts with ob- 
jectivity and understanding, avoiding 
the moralizing tone that permeates 
much of the literature on the subject 
of drug use and abuse. Practical con- 
siderations for the nursing care of the 
drug user make this chapter a partic- 
ularly welcome addition to the book. 

The unit "Crisis Intervention" is 
disappointingly weak in the nursing 
activities related to suicide and grief. 
Perhaps the sixth edition will contain' 
amplification of these topics. 

As an introduction to psychiatric 
nursing, this book is recommended as a 
basic text for all nurses, regardless of 
status or specialty. 

The Nurse and the Cancer Patient; A 
Programmed Texbook by Josephine 
K. Craytor and Margot L. Pass. 260 
pages. Toronto, J.B. Lippincott Co. 
of Canada Ltd., 1970. 
Reviewed by Phyllis Burgess, Direc- 
1 tor of Nursing, Ontario Cancer 
Clinic, Princess Margaret Hospital, 
Toronto, Ontario. 

This excellent contribution to nursing 
literature brings together an outline of 
scientific facts on malignant disease and 
its treatment. It also describes how 
patients' physical and emotional needs 
, can be met by a close nurse-patient 
52 THE CANADIAN NURSE 



relationship. The patients described, 
with their problems and triumphs, 
become real to the reader. 

This textbook aims to help the nurse 
find answers for herself. Particularly 
helpful to those charged with bedside 
care are the samples of conversations 
concerning fear, anxiety, and pain. 
Palliative treatment is well discussed, 
with emphasis on the pleasures of even 
short-term, partial independence. 

The chapter on death is written with 
sensitivity. Of merit is the author's 
ability to help us understand the lone- 
liness of final illness for the patient, his 
family, and the professional staff caring 
for him. 

The suggested readings at the end of 
each chapter are readily available to 
most nurses and should encourage 
further study. Review questions with 
answers, a glossary, and a bibliography 
conclude the text. 

Although primarily written for stu- 
dents. The Nurse and the Cancer Pa- 
tient will also make a useful short-study 
course for the staff nurse. Inservice 
coordinators, head nurses, and team 
leaders will find it a worthwhile desk 
manual, suitable for medical, surgical, 
pediatric, long-term, and radiation 
therapy units. 

Nursing in the Coronary Care Unit by 

LaVaughn Sharp and Beatrice Ra- 
bin. 2 13 pages. Toronto, J.B. Lippin- 
cott, 1970. 

Reviewed by M. Campbell, Head 
Nurse, Medical and Coronary Inten- 
sive Care Unit, St. Paul's Hospital, 
Vancouver, B.C. 

A large portion of the book deals with 
the anatomy and physiology of the 
heart, diagnostic procedures used to 
determine a myocardial infarct, and 
the complications that could arise along 
with cardiac arrhythmias. Drug therapy 
and nursing measures outlined in this 
portion are well detailed. 

A smaller pwrtion of the book deals 
with the general organization and func- 
tions of the coronary care unit, its 
physical plant and contents in regard 
to drugs and equipment. 

The text concludes with a small 
section on inservice education. There 
are some excellent chapters in the book. 
Those worth special mention are: 1. 
Organization and Function of the Cor- 
onary Care Unit, where such topics as 
the criteria for admission, discharge 



and policy making are discussed; 2. 
Psychological Responses in the Cor- 
onary Care Unit, where the advanced 
thinking of the authors is quite evident 
when describing the progressive care 
area for the patient with myocardial 
infarct. 

One of the weaker areas is the sec- 
tion on electrocardiography. Here 
the authors attempt to capsulate where 
volumes have been written, which is 
a difficult task. 

It is stated in the preface that this 
book would be of value to the student 
nurse, the nurse specialist, and the 
nursing administrator. A noble attempt 
is made to meet the needs of these 
various levels, but I do not feel the 
authors have succeeded. 

For the student nurse, certain topics, 
such as electrocardiography and recog- 
nition of basic arrhythmias, could be 
simplified, and more emphasis could 
be placed on the psychological support 
of the patient. However, the nurse 
specialist requires more depth, particu- 
larly in the field of electrocardiography. 
The nurse administrator requires more 
information regarding the organization 
and functions of the coronary care 
unit and about inservice education 
programs, although the book does 
give her an overview of the subject 
matter and problems related to coronary 
care nursing. 

References used show that each 
topic has been well researched and 
should be of value to hospitals contem- 
plating construction of a coronary care 
unit. 

Principles and Practice of Intravenous 
Therapy by Ada Lawrence Plummer. 
262 pages. Boston, Mass., Little, 
Brown and Company, 1970. Cana- 
dian Agent: J.B. Lippincott, Toronto. 
Reviewed by Alice MacLaren, In- 
structress and Head, Intravenous 
Team, Saint John General Hospital. 
Saint John, N.B. 

This book provides a text to help pre- 
pare members of the intravenous ther- 
apy team. With the increase in drug 
therapy via the venous route, better 
understanding of fluid and electrolyte 
balance, improvement of blood and 
blood products used in transfusions, 
specialized training in the techniques 
and responsibilities involved in intra- 
venous therapy is required by nurses. 
The book is well planned. It starts 
MARCH 1971 



with a short history of intravenous 
therapy, including the legal implica- 
tions of its use. Then it describes the 
types of equipment and their use, with 
illustrations and references to support 
the material. Applied anatomy and 
physiology are concisely presented. 
Techniques used in venipuncture, the 
preparation of infusion fluids, hazards 
and their prevention, and the respon- 
sibilities of the attending nurse are 
clearely delineated. 

The administration of drugs by 
venous infusion is well outlined. The 
advantages, dangers, and incompat- 
abilities of additives, and the respon- 
sibilities of the hospital committee, 
the physician, the IV therapist, and 
the attending nurse are given due 
emphasis. 

The author devotes three chapters 
to the transfusion of blood and blood 
components, and the withdrawal of 
blood samples. She includes tables of 
normal values of blood, plasma, and 
serum. 

Improvements in the collection and 
storage of blood have added to the 
knowledge of blood antigens and their 
antibodies (immuno-hematology), and 
have allowed blood transfusions to 
become an integral part of daily treat- 
ment for certain patients. The author 
again stresses the dangers and respon- 
sibilities inherent in this type of treat- 
ment. 

Although hypodermoclysis, the in- 
jection of fluids into subcutaneous 
tissues, has become less widely used 
for fluid replacement, the writer dis- 
cusses this method, citing its advantages 
and disadvantages. 

A chapter on the organization of an 
intravenous therapy department com- 
pletes the volume. 

The author is to be commended for 
providing a text for prospective mem- 
bers of an intra\enous therapy group. 
Though written from an American 
point of view, the material in this edi- 
tion is nevertheless easily adaptable to 
Canadian circumstances, and should 
prove valuable study material for the 
general duty nurse and the IV therapist. 



AV aids 



FILMS 

The Leaf and the Lamp 

The Leaf and the Lamp (English) or 
L' Infirmiere au Canada (French), the 
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MARCH 1971 



a show of hands... 





-^ 




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proves its smoothness 



NEW FORMULA ALCOJEL, with 
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THE CANADIAN NURSE 53 



i ^ 

Busy, busy 
little fingers. 
Busily spreading 
pinworms. 




Depend upon 

(pyrvinium parr 

to eliminate 



(pyrvinium pamoate Frosst) 



pinworms 
a singie dose 



Early detection, and treatment with 
Pamovin, can bring the usual unpleasant 
course of pinworms to an abrupt halt. 

It has been shown' that single-dose 
treatment with pyrvinium pamoate 
achieves an overall cure rate of 
96 percent. 

In the family or in institutions, pyrvinium 
pamoate (PAMOVIN) offers the advantages 
of "low cost, ease of administration, 
and effectiveness."^ 

Dosage: for both children and adults, a single 
dose of 1 tablet or 1 teaspoonful for every 
22 lbs. of body weight. 

Cautions: Occasionally, nausea, vomiting or 
gastrointestinal complaints may be encoun- 
tered but are seldom a problem on such 
short-term treatment. Stools may be coloured 
red. Suspension will stain clothing and fabrics. 

PAMOVIN Tablets of 50 mg. (red, film-coated), 
boxes of 6, and bottles of 24 and 100. 
Suspension (red), 50 mg. per 5 ml. teaspoonful, 
bottles of 30 ml., 4 and 16 fl. oz. 

References: 1. Beck, J. W.,Saavedra, D., 

Antell, G. J. and Tejeiro, B.: Am. J. Trop. Med. 
8:349, 1959. 2. Sanders, A. I. and Hall, W. H.: 
J. Lab. & Clin. Med. 56:413, 1960. 

Full inlormation on request. 



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The Spark of Life, especially produced 
for pacemaker users and their families, 
is now available from the General 
Electric Compay. 

This film defines, in lay terms, normal 
heart performance and the effects of 
heart block. It includes a demonstration 
and explanation of asynchronous and 
demand cardiac pacemakers, and shows 
how these devices help restore normal 
cardiac activity. Dr. Richard D. Judge, 
clinical associate professor of internal 
medicine, University of Michigan, 
narrates the film. 

Copies of the Spark of Life can be 
obtained from General Medical Sys- 
tems Limited, 3311 Bayview Avenue, 
Toronto, Ontario. 

New Canadian Film Catalog 

The newly-organized Association of 
Canadian Film Cooperatives has pub- 
lished a bilingual catalog, through the 
efforts of all the Canadian film-makers' 
cooperatives in Vancouver, Toronto, 
Montreal, and London, Ontario. The 
112-page catalog was printed with 
the aid of a Canadian Film Develop- 
ment Corporation grant and includes 
over 350 films ranging in length from 
one second to two hours. It is the 
largest source of Canadian films outside 
the National Film Board and includes 
over 20 feature films. Nearly all the 
filmmakers represented are indepen- 
dent. The films include almost every 
cinematic style with emphasis on the 
experimental. The free catalog is avail- 
able from the ACFC, 2026 Ontario St., 
E., Montreal 133, Quebec. 



parcel post, or ordinary mail — not 
freight) a roll of videotape appropriate 
to any of the five modes listed. The 
program requested will be recorded 
on the videotape supplied and returned 
to the client. Used tape is acceptable, 
if its quality has not deteriorated beyond 
reasonable standards. 

All duplicates are monochrome and 
at present only the following video- 
tape recording modes are available 
from NMAC: 

• Ampex 1100, Lowband, two-inch 
standard broadcast. Playable only on 
standard broadcast videotape recorders. 
Recorded at 1 5 ips Only. 

• Ampex 7500, Helical Scan, one- 
inch videotape recorded at 9.6 ips. 
Playable on 7000 series, 6000 series, 
5000 series, using standard Ampex 
one-inch format. 

• Ampex 660- B, Helical Scan, two- 
inch videotape recorded at 3.7 ips. 
Playable on 660 series and 1500 series. 

• IVC 820-C, Helical Scan, one-inch 
videotape recorded at 6.9 ips. Playable 
on all IVC one-inch series and on Bell 
& Howell 2000 series machines. 

• Sony EV-310, Helical Scan, one- 
inch videotape recorded at 7.8 ips. 
Playable on any Sony one-inch video- 
tape machine. 

Requests for the NMAC listing or for 
duplicating service should be addressed 
to the National Medical Audiovisual 
Center, Atlanta, Georgia 30333, U.S.A., 
Attention: Videotape Duplicating 
Service. 



Film Rejuvenation 

A new film rejunevation service is now 
available to Canadian film libraries 
through Bonded Services. Bonded 
Filmtreats' process can treat film stock 
that is scratched, damaged, stained, or 
worn out. The process treats negative 
or positive, 16 mm or 35 mm, black 
and white or color film and the base 
and emulsion on films. For further 
information write Jack McKay at Bon- 
ded Filmtreat, 205 Richmond Street 
West, Toronto 2B, Ont. ^ 



CHARLES e FROSST A CO. KMKLANO (MONTRCAl,! CANADA 



U.S. Medical Videotapes 
Available for Duplication 

The videotape duplication service of 
the National Medical Audiovisual 
Center, U.S. Department of Health, 
Education, and Welfare, is now avail- 
able to Canadian schools of nursing at 
no charge, except for the Canadian 
customs fee. 

All videotapes listed by the National 
Medical Audiovisual Center (NMAC) 
may be duplicated without charge on 
videotape that requesters must provide 
to the Center. The Center supplies this 
service only and does not honor loan 
requests. 

To secure this service, send (by air 



accession list 



Publications on this list have been 
received recently in the CNA library 
and are listed in language of source. 

Material on this list, except Reference 
items may be borrowed by CNA mem- 
bers, schools of nursing and other in- 
stitutions. Reference items (theses, 
archive books and directories, almanacs 
and similar basic books) do not go out 
on loan. 

MARCH 1971 




Requests for loans should be made 
on the "Request Form for Accession 
List" and should be addressed to: The 
Library, Canadian Nurses" Association, 
.SO The Driveway. Ottawa 4. Ontario. 

No more than iliree titles should be 
requested at any one time. 

BOOKS AND DOCUMENTS 

1. Li's aspects mUrobioto)iiqiies de I' hygiene 
lies denrees idimenuiires. Geneve. Organisa- 
tion mondiale de la Sante. Comite dexperts 
de rOMS reuni avec la participation de la 
FAO, 1968. 71p. (Its Serie de rapports tech- 
niques no. 399) 

2. Associate degree education for nursing — 
current issues, 1970; papers presented at 
the Third Conference of the Council of 
Associate Degree Programs held at Hono- 
lulu, Hawaii. March 4-6, 1970. New York. 
National League for Nursing. Dept. of Asso- 
ciate Degree Programs, 1970. 69p. 

3. The Canadian annual review for 1969 
edited by John T. Saywell. Toronto, Univ. 
of Toronto Press, 1970. 514p. 

4. Elementary textbook of anatomy and 
physiology applied to nursing by Janet T.E. 
Riddle. London, Livingstone, 1969. 155p. 

5. The government of Canada. .'>th ed. edited 
by Robert MacGregor Dawson, revised by 
Norman Ward. Toronto, University of To- 



ronto Press, 1970. 569p. (Canadian govern- 
ment series) 

6. Histoire de la profession infirinii're au 
Quebec par Edouard Desjardins. Suzanne 
Giroux et Eileen C. Flanagan. Montreal, 
Association des Infirmiers et des Infirmie- 
res de la Province de Quebec. 1970. 270p. 

7. Maternity nursing by Constance Lerch. 
Saint Louis, Mosby, 1970. 360p. 

8. National Conference on Cataloguing 
Standards. Ottawa, May 19-20, 1970, papers. 
Ottawa, National Library of Canada, 1970. 

9. Nursing studies index: an annotated guide 
to reported studies, research methods, ami 
historical and biographical materials in 
periodicals, books, ami pimiphlets published 
in English, vol. 2, 1930-1949 by Virginia 
Henderson. Philadelphia, Lippincott, 1970. 
1037p. 

10. Obstetrics by J. P. Greenhill from the 
original text of Joseph B. DeLee. 13th ed. 
Philadelphia, Saunders. 196.'i. 1246p. 

1 1 . Papers presented at the Interprovincial 
Conference on French-language Textbooks. 
Ottawa, Feb. 27 and 28, 1970. Ottawa, Ca- 
nadian Teachers Federation, 1970. 6pts in 1. 
12. Proceedings of American Library Asso- 
ciation annual conference. 1969. Chicago, 
American Library Association, 1970. 160p. 
\'i. Public education about cancer, recent 
research and current programmes 1969. 
Geneva, International Union Against Can- 
cer, 1970. 104p. (UICC. Technical Report 
Series, vol.6) 



14. Who's who of American women with 
world notables. 6th ed. Chicago, A.N. Mar- 
quis, 1970-71. 1386p. 

PAMPHLETS 

\5. The accreditation progriunme of the 
Canadian Council on Hospital Accredita- 
tion by Nicole Du Mouchel; conference 
given at the Joint Staff Meeting. Registered 
Nurses" Association of Ontario, Mar. 9, 
1970. Toronto, 1970. 1 3 p. 

16. L'eaii par W.V. Morris. Ottawa. Direc- 
tion des Eaux interieures, Ministere de 
TEnergie des Mines et des Ressources, 1969. 
.'i9p. 

17. Public Affairs Committee. Pamphlets. 
New York. 

no.38A The facts about cancer by Dallas 
Johnson. 1957. 28p. 

no.l 18A /l/(o/(o//.s7?i (( sickness that can 
be beaten by Alton L. Blakeslee. 1964. :8p. 

no.l20A Toward mental health by George 
Thorman and Elizabeth Ogg. 1967. 28p. 

no. \26A Rlieiiinaiic fever by Marjorie 
Taubenhaus. 19.^8. 20p. 

no. 1 37 Kiww your heart by Howard Blake- 
slee. 1948. 20p. 

no.l49 Woii' /() tell your child about se.x 
by James L. Hymes. 1959. 28p. 

no.l56C What we can do to wipe out TB 
by Alton L. Blakeslee and Jules Saltman. 
1968. 20p. 

no. 1 68 Your blood pressure <md your 
arteries by Alexander L. Crosby. 1951. 20p. 



SCHOLARSHIPS IN FAMILY PLANNING 

In 1969 G. D. Searie of Canada, Linnited, established the Searle Scholarship Progronn for Canadian nurses. 
This Program is being continued, and during 1971 up to 8 scholarships in family planning will be offered 
under the following conditions: 

1. Applications will be considered from any graduate nurse employed full-time in Canada, regard- 
less of citizenship or training school attended. 

2. Awards will be made on the basis of expressed interest in family planning education and the 
applicant's present and future prospects for making use of family planning clinic training. 

Successful applicants will, at Searle expense, travel from any point in Canada to Chicago, be provided 
with accommodation in that city, attend a 2 week course at the Chicago Planned Parenthood Clinic, and 
receive $150 for meals and incidental expense. Instruction is available in English only. 

Applications for the first 1971 course must be received no later than April 15, 1971. 

This program should be of special interest to nurses engaged in Public Health work, or in School or 
College Health Programs, but is not restricted to these groups. Awards are made entirely at the dis- 
cretion of the Scholarship Selection Committee. Names of the 12 previous scholarship winners are 
available on request. 

Application forms may be obtained from: 
Reference and Resource Program, 

C. D. SEARLE & CO. OF CANADA, LIMITED 

390 Orendo Road 
Bramalea, Ontario 



MARCH 1971 



THE CANADIAN NURSE 55 



accession list 



no.295A Blindness — ability, not 
hilily by Maxine Wood. 1968. 28p. 



disii- 



(Continued from page 55) 

no. 172 When mental illness strikes your 
family by Kathleen Cassidy Doyle. 1951. 28p. 

no. 1 82 Getting ready to retire by Kathryn 
Close. 1952. 28p. 

no. 184 Won- to live with heart trouble. 

1959. 28p. 

no.220A Cigarettes and health by Pat Mc- 
Grady. 1960. 20p. 

no. 229 Psychologists in action by Eliza- 
beth Ogg. 1955. 28p. 

no. 234 Coming of age: problems of teen- 
agers by Paul H. Landis. 1956. 28p. 

no. 264 Your child's emotional health by 
Anna W.M. Wolf. 1958. 28p. 

no. 267 Your operation by Robert M. 
Cunningham. 1958. 20p. 

no.272 IVill my baby be born normal by 
Joan Gould. 1958. 20p. 

no. 274 Yoii and your adopted child by 
EdaJ. LeShan. 1958. 28p. 

no. 286 When a family faces cancer by 
Elizabeth Ogg. 1959. 28p. 

no.288 How retarded children can be 
helped by Evelyn Hart. 1959. 29p. 

no. 291 A Your child may be a gifted child 
by Ruth Carson. 1959. 20p. 

no.293 The only child by Eda J. LeShan. 

1960. 20p. 



GOVERNMENT DOCUMENTS 

18. Women's Bureau. Utws of interest to 
women of Alberta. Rev. Edmonton, Queen's 
Printer. 1970. 38p. 

Canada 

19. Bureau of Statistics. Canadian statistical 
review. Annual supplement. 1969. 42p. 

20. Conseil du Tresor du Canada. Negocia- 
tions collectives et procedures de reglement 
des griefs dans la fonction puhlique federale; 
manuel d'enseignement sequentiel prepare 
par Claire C. Nault avec la collaboration de 
la Division des relations de travail, service 
du personnel, Ministere de la Main-d'oeuvre 
et de I'lmmigration. 3.ed. Ottawa, Conseil 
du Tresor du Canada, 1970. I57p. 
21.Dept. of Energy. Mines and Resources. 
Water by W.V. Morris. Ottawa, Queen's 
Printer. 1969. 59p. 

22. Dept. of National Health and Welfare. 
Commission of Inquiry into the Non-Med- 
ical Use of Drugs. Interim report. Ottawa, 
Queen's Printer. 1970. 320p. 
23. — .Research and Statistics Directorate. 
Earnings of dentists in Canada. 1959-1968. 
Ottawa. 1970. 41 p. 

24. Equipe specialisee en Relations de Tra- 
vail. Le syndicalisme an Quebec: structure 
et moiivement par J. Dofny et P. Bernard. 
Ottawa. Imprimeur de la Reine, 1968. 1 17p. 
(Canada. Equipe specialisee en relations 
de travail etude no. 9) 



25. Ministere du Travail. Bureau de la Main 
d'oeuvre feminine. Les meres an travail et 
les modes de garde de letirs enfants. Ottawa. 
Imprimeur de la Reine, 1970. 57p. 

26. Minister of Veterans' Affairs. Pensions 
for disability and death related to military 
service. Ottawa, Queen's Printer, 1969. 16p. 

27. Royal Commission on Bilingualism and 
Biculturalism. Bilingualism and hicultiira- 
lism in the Canadian House of Commons 
by David Hoffman and Norman Ward. 
Ottawa, Queen's Printer, 1970. 295p. (Can- 
ada. Royal Commission on Bilingualism 
and Biculturalism. Documents no. 3) 

28. — .Constitutional adaptation and Cana- 
dian federalism since 1945 by Donald V. 
Smiley. Ottawa, Queen's Printer, 1970. 155p. 

29. Task Force on Labour Relations. Re- 
sponsible decision-making in democratic 
trade unions by Earl E. Palmer. Ottawa, 
Queen's Printer, 1970. 423p. (Canada. Task 
Force on Labour Relations study no. 1 1 ) 
Quebec 

30. Commission d'Enquete sur la Sante et 
le Bien-etre social. Rapport, tome 4, La 
Same. Quebec, Ville, Gouvernement du 
Quebec, 1970. 4pts. 

31. — .Rapport, tome 7. Les professions et 
la societe. Quebec, Ville, Gouvernement du 
Quebec, 1970. 102p. 
United States 

32. Dept. of Health, Education and Welfare. 
Public Health Service. Bibliography of the 
history of medicine. Bethesda, Maryland, 
U.S. Government Printing Office, 1968. 299p. 



Request Form for "Accession List" 
CANADIAN NURSES' ASSOCIATION LIBRARY 

Send this coupon or facsimile to: 

LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario 

Please lend me the following publications, listed in the issue of The 

Canadian Nurse, or add my name to the waiting list to receive them when available: 

Item Author Short title (for identification) 

No. 



Requests for loans will be filled in order of receipt. 

Reference and restricted materia! must be used in the CNA library. 

Borrower Registration No. 



Position 



Address 

Date of request 



56 THE CANADIAN NURSE 



MARCH 1971 



DO YOU 

WANT TO HELP 

YOUR PROFESSION? 

Then fill out and send in the form below 

REMITTANCE FORM 
CANADIAN NURSES' FOUNDATION 

50 The Driveway, Ottawa 4, Ontario 

A contribution of $ payable to 

J the Canadian Nurses' Foundation is enclosed 
and is to be applied as indicated below: 

IVIEMBERSHIP (payable annually) 

Nurse Member — Regular $ 2.00 

Sustaining $ 50.00 

Patron 



$500.00 

Public Member — Sustaining $ 50.00 
Patron $500.00 

BURSARIES $ RESEARCH $ . 

MEMORIAL $ in memory of . 



Name and address of person to be notified of 
this gift 



REMITTER 

Address . 
Position . 
Employer 



(Print name in full) 



N.B.: CONTRIBUTIONS TO CNF 
ARE DEDUCTIBLE FOR INCOME TAX PURPOSES 



Index 

to 

advertisers 

March 1971 



Baxter Laboratories of Canada 23, 27 

BDH Pharmaceuticals 53 

Burroughs Wellcome & Co. (Canada Ltd 29 

Charles E. Frosst & Co 25, 54 

Gomco Surgical Manufacturing Corp 12 

Hollister Inc 14 

LV. Ometer, Inc 19 

Johnson & Johnson Limited 2 

LaCross Uniform Corp 11 

Lakeside Laboratories (Canada) Ltd 30 

J.B. Lippincott Company of Canada Limited 9 

McCallan & Associates Limited Cover IV 

C.V. Mosby Company, Ltd 15 

Octo Laboratory, Ltd 6 

Parke, Davis & Company Ltd 10 

Professional Tape Co 24 

Reeves Company 5 

W.B. Saunders Company Canada Ltd 1 

Schering Corporation (Canada) Limited 21 

G.D. Searle & Co. of Canada Limited 55 

White Sister Uniform, Inc Cover II, III 

Winley-Morris Co. Ltd 17 



Advertising 

Manager 

Ruth H. Baumel, 

The Canadian Nurse 

50 The Driveway 

Ottawa 4, Ontario 

Advertising Representatives 
Richard P. Wilson 
219 East Lancaster Avenue 
Ardmore, Penna. 19003 

Vance Publications, 
2 Tremont Crescent 
Don Mills, Ontario 

Member of Canadian 
Circulations Audit Board Inc. 



MARCH 1971 



THE CANADIAN NURSE 



71 



PROVINCIAL ASSOQATIONS OF REGISTERED NURSES 



Alberta 

Alberta Association of Registered Nurses, 
10256 — 1 12 Street, Edmonton. 
Pres.: M.G. Purcell; Pies. -Elect: R. Erick- 
son; Vice-Pres.: D.E. Huffman. A.J. Prowse. 
Commillees — Niirs. Serv.: G. Clarke; 
Niirs. Ediic: G. Bauer; Staff Nurses: L.A. 
Meighen; Siiperv. Nurses: L. Bartlett; Soc. 
& Econ. Welf.: 1. Mossey. Provincial Office 
Staff — Puh. Rel.: D.J. Labelle; Employ. 
Rel.: Y. Chapman; Committee Advisor: 
H. Cotter: Registrar: D.J. Price; Exec. Sec: 
H.M. Sabin; Office Manager: M. Garrick. 

British Columbia 

Registered Nurses' Association of British 
Columbia. 2130 West 12th Avenue. Vancou- 
ver 9. 

Pres.: M.D.G. Angus; Past Pres.: M. Lunn; 
Vice-Pres.: R. Cunningham, A. Baumgart; 
Hon. Treasurer: T.J. McKenna; Hon. Sec: 
Sr. K. Cyr. Committees — Nurs. Edttc: 
E. Moore; Nurs. Serv.: J.M. Dawes; Soc. 
& Econ. Welf: R. Mcfadyen; Finance: 
T.J. McKenna: Leg. & By-Laws: Norman 
Roberts: Puh. Rel.: H. Niskala; Exec. Di- 
rector: F.A. Kennedy; Registrar: H. Grice; 
Communications Consult.: C. Marcus. 

Manitoba 

Manitoba Association of Registered Nurses, 
647 Broadway Avenue, Winnipeg 1. 
Pres.: M.E. Nugent; Past Pres.: D. Dick; 
Vice-Pres.: F. McNaught, Sr. T. Caston- 
guay. Committees — Nurs. Serv.:i. Robert- 
son; Nurs. Educ: S.J. Winkler; Soc. & Econ. 
Welf: S.J. Paine: Legis.: M.E. Wilson; Ac- 
crediting: M.E. Jackson; Board of Examiners: 
E. Cranna; Educ. Fund: M. Kullberg; Fi- 
nance: B. Cunnings: Pub. Rel. Officer: T.M. 
Miller; Registrar: M. Caldwell; Exec. Di- 
rector: B. Cunnings: Coordinator of Contin. 
Educ: H. Sundstrom. 

New Brunswick 

New Brunswick Association of Registered 
Nurses, 23 1 Saunders Street, Fredericton. 
Pres.: H. Hayes; Past Pres.: I Leckie; Vice- 
Pres.: A. Robichaud, L. Mills; Hon. Sec: 
M. MacLachlan. Committees — Soc. & Econ. 
Welf: B. Leblanc; Nurs. Educ: Sr. H. Ri- 
chard; Nurs. Serv.: Sr. M.L. Gaffney; Fi- 
nance: A. Robichaud; Legisl.: M. MacLach- 
lan; Exec. Sec: M.J. Anderson; Acting 
Registrar: M. Russell; Adv. Com. to Schools 
of Nurs.: Sr. F. Darrah; Nurs. Asst. Comm.: 
A. Dunbar; Liaison Officer: N. Rideout; 
Employ. Rel. Officer: G. Rowsell. 

Newfoundland 

Association of Nurses of Newfoundland, 
67 LeMarchand Road, St. John's. 
Pres.: P. Barrett; Past Pres.: E. Summers; 
Pres. Elect.: E. Wilton; 1st Vice-Pres.: J. 
Nevitt; 2nd Vice- Pres.: E. Hill; Committees 
— Nurs. Educ: L. Caruk; Nurs. Serv.: A. 
Finn; Soc. & Econ. Welf: L. Nicholas; 

72 THE CANADIAN NURSE 



Exec. Sec: P. Laracy; A.ssl. Exec. Sec: M. 
Cummings. 

Nova Scotia 

Registered Nurses' Association of Nova 
Scotia, 6035 Coburg Road, Halifax. 
Pres.: J. Fox; Past Pres.: J. Church; Vice- 
Pres.: Sr. C. Marie, M. Bradley, E.J. Dob- 
son; Advisor, Nurs. Educ: Sr. C. Marie; 
Advisor. Nurs. Serv.: J. MacLean. Com- 
mittees — Nurs. Educ: Sr. J. Carr; Nurs. 
Serv.: G. Smith; Soc. & Econ. Welf: Roy 
Harding; Exec. Sec: F. Moss; Pub. Rel. Of- 
ficer: G. Shane; Employ. Rel. Officer: M. 
Bentley. 

Ontario 

Registered Nurses' Association of Ontario, 
33 Price Street, Toronto 289. 
Pres.: L.E. Butler; Pres. Elect: M.J. Flaherty. 
Committees — Socio.-Econ. Welf.: M.E.B. 
Purdy; Nursing: E. Valmaggia; Educator: 
A.E. Griffin; Administrator: M.A. Liddle; 
Exec. Director: L. Barr; Asst. Exec. Di- 
rector: D. Gibney; Employ. Rel. Director: 
A.S. Gribben; Coord., Formal Contin. Educ 
Program: L.C. Peszat; Director, Prof. Devel. 
Dept.: CM. Adams: Pub. Rel. Officer: 1. 
LeBourdais; Regional Exec. Sec: I.W. 
Lawson, M.I. Thomas, F. Winchester. 

Prince Edward Island 

Association of Nurses of Prince Edward 
Island, 188 Prince Street, Charlottetown. 
Pres.: C. Corbett: Past Pres.: B. Rowland; 
Vice-Pres.: B. Robinson; Pres. Elect.: E. 
MacLeod. Committees — Nurs. Educ: 
M. Newson; Nurs. Serv: S. Griffin; Pub; 
Rel.: C. Gordon; Finance: Sr. M. Cahill; 
Legis. & By-Laws: H.L. Bolger; Soc. & 
Econ. Welf: F. Reese; Exec. Sec- Registrar: 
H.L. Bolger. 
Quebec 

Association of Nurses of the Province of 
Quebec, 4200 Dorchester Boulevard, West, 
Montreal. 

Pres.: H.D. Taylor; Vice Pres.: (Eng.j S. 
O'Neill, R. Atto; (Fr.): R. Bureau, M. La- 
lande; Hon. Treas.: J. Cormier; Hon. Sec: 
R. Marron. Committees — Nurs. Educ: 
M. Callin, D. Lalancette; Nurs. Serv.: E. 
Strike, C. Gauthier; Labor Ret.: S. O'Neill. 
G. Hotte; School of Nurs.: M. Barrett, P. 
Provencal; Legis.: E.C. Flanagan, G. (Char- 
bonneau) Lavallee; Sec-Registrar: N. Du 
Mouchel. 
Saskatchewan 

Saskatchewan Registered Nurses Association, 
2066 Retallack Street, Regina. 
Pres.: M. McKillop; Pa.^t Pres.: A. Gunn; 
1st Vice-Pres.: E. Linnell; 2nd Vice-Pres.: 
C. Boyko. Committees — Nurs. Educ: C. 
O'Shaughnessy; Nurs. Serv.:}. Belfry; Chap- 
ters & Pub. Rel.: M. Harman; Soc. & Econ. 
Welf: E. Fyffe; Exec. Sec: A. Mills; Reg- 
istrar: E. Dumas: Employ. Rel. Officer: A. 
M. Sutherland: Nurs. Consult.: E. Hartig; 
A.ssl. Registrar: }. Passmore. 



yV CANADIAN 



ASSOCIATION 



Soard of Directors 

President E. Louise Miner 

President-Elect 

Marguerite E. Schumacher 

1st Vice- President 

Kathleen G. DeMarsh 

2nd Vice-President 

Huguette Labelle 

Representative Nursing Sisterhoods 

...Sister Cecile Gauthier 
Chairman of Committee on Social & 

Economic Welfare ..Marilyn Brewer 
Chairman of Committee on 

Nursing Service ...Irene M. Buchan 
Chairman of Committee on Nursing 
Education Alice J. Baumgart 



Provincial Presidents 

AARN M.G. Purcell 

RNABC M.D.G. Angus 

MARN M.E. Nugent 

NBARN H. Hayes 

ARNN P. Barrett 

RNANS J. Fox 

RNAO L.E. Butler 

ANPEl C. Corbett 

ANPQ H.D. Taylor 

SRNA M. McKillop 



National Office 

Executive 

Director Helen K. Mussallem 

Associate Executive 

Director Lillian E. Pettigrew 

General 

Manager Ernest Van Raalte 



Research and Arlvisory Services 

Nursing 
Coordinator Harriett J.T. Sloan 

Research Officer H. Rose Imai 

Library Margaret L. Parkin 

Information Services 

Public Relations Doris Crowe 

Editor, The Canadian 

Nurse Virginia A. Lindabury 

Editor, L'infirmiere 

canadienne Claire Bigue 



MARCH 197 



April 1971 






ITY OP OTTA'VA 

-ISRARY 



OTiAV,'A 2, ^^_ 

l2-71-l2-.70-C.V-Pi) 



The 



Canadian 
Nurse 





research in nursing practice 
— first national conference 

myo-electric control — 

one more aid for the amputee 

basilar aneurysms 




so VERY . 





WHITE 
SISTER 



IN WHITE 

In Super Supreme Flat 
Knit Polvester/Nylon 

#0943 
$18.98 

Sizat: 8-18 



"IMAGE SPORTIFF" is created by cresent shaped pockets. Brass ring front zipper closing. Fashion 
fitting darts, front and back. Action sleeve gussets. Available as full pant dress only. 
Pants — Elastic waist, flare bottoms unhemmed for individual length adjustment 
#0943— In "Royale" Fortrel Polyester/Nylon Oxford Knit 

Lime and Gold at S24.00 

Sizes: 8-18 
-0943 — IN WHITE: "Super Supreme" Polyester/Nylon 

Flat Knit 

White only at S18.98 

Sizes 8-18 




Nursing has changed! 



Thousands of nurses used the first edition of "Stryker" to bring their 
nursing knowledge up to date. Now the book itself has been updated 
and made even more valuable in a new Second Edition. 

"Back to Nursing" was designed to meet the needs of nurses returning 
to active practice after an absence. It worked superbly well. So well, in 
fact, that nurses who had been practicing all along started using it to 
polish up their knowledge. In the new edition Miss Stryker writes, "Since 
continuous employment in itself does not guarantee current knowledge 
and updated information, some form of ongoing study and continuing 
education is needed by all of us. For these reasons the second edition of 
this book has attempted to assist the practicing nurse as well as the 
refresher. The aims of the book are five-fold: first, to describe the general 
environment in which nursing must function; second, to provide an 
overview of new roles and current practice in the major areas of nursing; 
third, to suggest resources for further study; fourth, to assist the prac- 
titioner to implement her ideas; and fifth, to assist the refresher to locate 
a satisfying work situation." 

This book is uniquely designed to help you realize your aims. 

Back to Nursing, Second Edition. By Ruth Perin Stryker, R.N., B.S., M.A., 
Director of Nursing Education, American Rehabilitation Foundation. 
About 368 pages, illustrated. About $9.20. Just ready. 



Guyton: BASIC HUMAN PHYSIOLOGY: Normal 
Function and Mechanisms of Disease. 
By Arthur C. Guyton, M.D., University of Mississippi 
Medical School. 

A careful condensation of Guyton's standard med- 
ical text, this new book is designed for students in 
the health professions. It emphasizes general and 
cellular physiology, biochemistry, and material on 
bone, teeth, and oral physiology. All the facts are 
there; omitted are discussions of alternative hypo- 
theses and extensive references. The authority, 
lucidity, and pertinence for which the big Guyton 
is famous come through clearly in this new, more 
compact book. 

About 650 pages with 430 illustrations. About $13.50. 
Just ready. 



THE NURSING CLINICS OF NORTH AMERICA 

The latest (March) issue of the famous Nursing 
Clinics focuses on two problem areas: Care of the 
Newborn, with Laurine Cochran of Cincinnatti Gen- 
eral Hospital as Guest Editor, and Assessment as 
Part of the Nursing Process, with Prof. Elizabeth 
Giblin of the University of Washington School of 
Nursing as Guest Editor. The 18 timely articles that 
make up these two symposia are typical of the 
authoritative, informative, and practical information 
that fills every issue of the Nursing Clinics. Four 
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APRIL 1971 



CN 4-71 
THE CANADIAN NURSE 





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The 



Canadian 
Nurse 



A monthly journal for the nurses of Canada published 

in English and French editions bv the Canadian Nurses' Association 




Volume 67, Number 4 



April 1971 



33 Research, Apple Juice, and Daffodils — 

A Good Combination D.J. Kergin 

34 National Conference on Research in 
Nursing Practice 

4 1 Management of Parkinson's Disease With 

L-dopa Therapy E. Tyler 

43 The Cancer Patient W. Stockdale 

44 Myo-electric Control — One More Aid 

For The Amputee R.N. Scott 

49 Basilar Aneurysms M.J. Derdall 

53 Information for Authors 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 



4 Letters 

24 Names 

30 In a Capsule 

55 Research Abstracts 

58 Acession List 



1 1 News 

28 New Products 

54 Dates 

56 AV Aids 

80 Index to Advertisers 



Executive Director: Helen K. Mussallem • 
Editor: Virginia A. Lindabury • Assistant 
Editor: Liv-Ellen Lockeberg • Editorial As- 
sistant: Carol .\. Kotlarsky • Production 
Assistant: Elizabeth A. Stanton • Circula- 
tion Manager: Ben I Darling • Advertising 
Manager: Ruth H. Baumel • Subscrip- 
tion Rales: Canada: one year. S4.50; two 
years, S8.00. Foreign: one year, $5.00; two 
years. S9.00. Single copies: 50 cents each. 
Make cheques or money orders payable to the 
Canadian Nurses' Association. • Change of 
Address: Six weeks" notice; the old address as 
well as the new arc necessary, together with 
registration number in a provincial nurses' 
association, where applicable. Not responsible 
for journals lost in mail due to errors in 
address. 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in India ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles 
sent, nor to indicate definite dates of 
publication. 

Postage paid in cash at third class rale 
MONTREAL, P.O. Permit No. 10,001. 
50 The Driveway. Ottawa 4. Ontario. 
O Canadian Nurses' Association 1971. 



Editorial 



APRIL 1971 



Anyone who has completed a research 
project naturally wants to share her 
findings. The reason is simple: she has 
reached certain conclusions that may 
be valuable to others engaged in similar 
studies or to those working in clinical 
settings who can test and perhaps im- 
plement her findings. 

But how does she disseminate infor- 
mation about her research? This ques- 
tion was raised at the national con- 
ference on research in nursing practice 
held in Ottawa in February. There was 
consensus that few nursing research 
projects were being shared with others, 
and that in the long run it was the pa- 
tient who suffered most from this lack 
of communication. 

We believe the problem can be cor- 
rected, and we are willing — in fact, 
eager — to help. However, the solution 
requires the cooperation of both the 
researcher and the institution or agency 
that sponsored her project. 

The best way to bring a completed 
research project to the attention of aL 
nurses is to send a copy of it to the 
Canadian Nurses" Association's Repos- 
itory Collection. Studies received ir 
this Collection are listed monthly ir 
The Canadian Nurse and are available 
on interlibrary loan from the CNA 
library. Abstracts of these studies an 
then published in CNJ. (Credit — lonj 
overdue — is given to Dr. Moyra Allen 
associate professor at McGill's Schoo 
For Graduate Nurses, who first suggest 
ed that research abstracts be publishec 
in the journal.) 

But how many individuals or institu 
tions take advantage of this CNA serv 
ice by sending in their completed re 
search papers? Very few. The CN/* 
librarian estimates that the Repositon 
Collection has received only one-thirc 
of all studies. 

The researcher should consider ai 
additional way to share her findings 
by writing ar. article, based on he; 
study, for publication in The Canadiai 
Nurse. Frequently we have approachec 
nurses to write such articles and havt 
either been turned down or have receiv 
ed a "yes" — but no article. 

Perhaps we haven't pushed enough 
Maybe our tactics should change. Ir 
future, we will chase, not "approach,' 
these nurses, because we, too, believ( 
research tlndings should be sharet 
with all those who are interested o 
involved in upgrading nursing practice 

— V.A.L 

THE CANADIAN NURSE 3 



letters 



Letters to the editor are welcome. 

Only signed letters will be considered for publication, but 

name will be withheld at the writer's request. 



Student is "turned off" 

Although I have not yet graduated, I 
have already been turned off by the 
great majority of my nursing colleagues. 
The idealistic conception of "nurse" 
that I had on entering nursing has deter- 
iorated as my contacts with nurses have 
increased. I have become disillusioned 
with this so-called career in compas- 
sion. My greatest fear as my graduation 
approaches is that I shall follow the 
footsteps of those who form the greater 
part of the nursing profession, for I 
have no doubt that they were every bit 
as conscientious as I at the outset of 
their careers. 

But what I see now disgusts me and 
makes me ashamed to call myself a 
nurse. Nursing care is mediocre, no- 
where approaching standards learned in 
the schools. Nurses dress sloppily. 
They, more than any other group in the 
hospital, resist the change and innova- 
tion so necessary to improve nursing 
care in this changing world. They rely 
on doctors to assume the responsibility 
that should be theirs. They take extend- 
ed coffee and lunch breaks and then 
complain that they don't have time to 
give proper patient care. They don't' 
support their professional organization, 
yet have the nerve to sit back and com- 
plain about the poor wages, about being 
overworked, and talk about wanting 
professional status. 

I see our nursing leaders fighting for 
these things and getting no support 
from these apathetic grumblers. And 1 
see that they are the greatest obstacle 
to progress in nursing. I feel that I am 
beaten before I even start. I have little 
faith in my fellow nurse. 

I see the day coming soon when the 
registered nurse will be phased out. 
She is outliving her usefulness by cling- 
ing to the past and by allowing herself 
to become second-rate. Hospital ad- 
ministrators will soon learn that it is 
more economical and just as efficient 
to employ well-trained registered nurs- 
ing assistants, for they can perform 
every bit as well at the lowered stand- 
ards nurses have set for themselves. 
No doubt there will be an uproar from 
nurses and others. The patient needs 
the added skill and training that the 
registered nurse has. Of course he does; 
but he isn't getting it now, so why should 
the hospital pay for services not render- 
ed? 

I send a plea to all nurses. It would 
4 THE CANADIAN NURSE 



take such a small effort on the part of 
each one to bring our profession up to 
the standard I know it can reach. Every 
nurse has learned how to give not just 
good, but optimal, nursing care. Every 
nurse has the skill and knowledge to 
give that care. But she has to use it. 
There will be no room for the mediocre 
nurse in the hospitals of tomorrow. 
She will be replaced if she does not 
shape up. 

If less effort were put into talking 
about professionalism and more into 
living up to professional standards, we 
would be a lot better off. The only thing 
that can improve the status of nursing 
is action — active effort on the part of 
every nurse to improve herself. Please 
try. For your own sakes. — Elizabeth 
Jordan, 4th year nursing student. Uni- 
versity of Toronto. 



A word of thanks 

The following letter, dated December 
20, 1970, was received by Mary Burton 
of Montreal. It is printed in the hope 
that the writer's unknown benefactor 
will read it. 

We four members from The Japanese 
Nursing Association were invited to 
your home on the way to the closing 
ceremony of the International Council 
of Nurses in 1969. We enjoyed our 
conversation and thank you very much. 
I have a favor to ask you. When I 







for employment or bursaries write: 

Director in Chief 

VICTORIAN ORDER OF NURSES 

FOR CANADA 

5 Blackburn Avenue 

Ottawa 2, Ontario 



arrived at the Montreal airport, I lost 
my suitcase. While I was at a loss what 
to do, a lady of the Canadian Nurses' 
Association tried to find my suitcase. 
She looked for it with me and took me 
to the airfxjrt counter, fxjlice office, 
etcetera, and asked them if they could 
find my luggage. I do appreciate her 
very much. I shall not forget all her 
kindness extended to me. I would like 
to express my hearty thanks. Will you 
ask the Canadian Nurses' Association 
office about it and let me know her 
name and address? I tried to ask my- 
self, but I haven't got the address. I'm 
very sorry to bother you. 

Will all the kindest wishes for good 
health and good fortune. — Kimiko 
Kinoshita, ch Himaraya, 26-22 6, 
chotne Kinuta-Machi, Setagaya-ku, 
Tokyo, Japan. 



More comments on abortion 

I agree that the Canadian Nurses' Asso- 
ciation should formulate a policy on 
abortion. It is a matter that affects 
Canadian nurses not only professionally 
but also personally, since the majority 
of nurses are female. The CNA should 
be one of the first to take a stand, along 
with each cf the provincial associations, 
so that Canadians in general will be 
aware of professional opinions before 
making their own decisions. Nurses 
must make their voices heard in Otta- 
wa, where these important decisions 
are now made. 

I firmly believe that abortion must 
be a matter between the patient and her 
doctor and that it should be available 
to all. 

However, abortion should not be- 
come a method of birth control. In 
addition to reform in abortion availabil- 
ity, we must also reform our methods of 
providing family planning services. The 
departments of health in every province 
must become actively involved in setting 
up enough clinics to provide full family 
planning services for the whole prov- 
ince. If our governments and our profes- 
sional organizations would concentrate 
on providing this type of service, the 
urgent need for abortions would de- 
cline. Some abortions would still be 
needed, but any woman would rather 
prevent a pregnancy than abort. As the 
situation is now, however, reliable 
birth control information and services 
are not available to all women. 

APRIL 1971 



I believe this type of clinic is our 
most immediate need and the remedy 
seems to be much simpler and cheaper 
than abortion reform. The operation of 
these clinics would certainly be less 
expensive than providing the hospital 
beds needed if abortion became truly 
a medical matter tomorrow. — Marsha 
Cleary, Sudbury, Ontario. 

In her letter to the editor (February, 
1971), Sister Marie Simone Roach 
raises philosophical and ethical issues 
regarding therapeutic abortion and the 
responsibility ofnurses. Included among 
her arguments is a narrow interpretation 
of the International Council of Nurses 
Code of Ethics. What Sister Roach 
seems to overlook is the importance of 
the viability of the human family unit 
and the responsibility of its decision- 
making members to ensure the continu- 
ed welfare of that unit. 

Nurses do indeed have an ethical 
responsibility "to conserve life, to 
alleviate suffering and to promote 
health." A restrictive interpretation of 
the Code should not be the excuse that 
prevents nurses from leaving parents 
free to consider the advisability of a 
therapeutic abortion. 

The nurse's responsibility is to pro- 
vide necessary therapeutic care, includ- 
ing supjxtrt, whatever the decision may 
be. If the nurse's ethical or religious 
beliefs prevent her from providing this 
care, then she should ensure that 
another is available to do so. To do 
less or to impose her own values on the 
mother and family is a potent violation 
of the ICN Code. 

Any ethical proscription against 
therapeutic abortion reflects the con- 
science of the individual nurse, not 
the profession. — Dorothy J. Kergin, 
Professor of Nursing, McMaster Uni- 
versity, Hamilton, Ontario. 

I was appalled to see that a registered 
nurse could actually believe that abor- 
tion is right and should be considered 
a private matter between the patient and 
her doctor (Letters, Dec. 1970). How 
can this be so? Isn't abortion murder? 
Does not life begin with conception? 
And does this not mean that the fetus 
has a soul? Therefore, is not the taking 
of a life, even a life in the fetal state, 
murder? 

Who are we to stand in judgment of 
who should have the right to be born 
and who should not? Have not many 
of the mentally and physically handi- 



Letters Welcome 

Letters to the editor are welcome. Be- 
cause of space limitation, writers are 
asked to restrict their letters to a 
maximum of 350 words. 



capped proven their worth in this world? 
I don't see how so many who call them- 
selves Christians can break or even 
consider breaking the commandment 
"Thou Shalt Not Kill." 

A few weeks ago I read an article 
called "The Fetus in a Pail." My feel- 
ings against abortion have always been 
strong, but after reading this article, 
they became even stronger. I could 
imagine how sick 1 would have felt, 
had I been the nurse asked to scrub and 
assist in that abortion, watching a live 
fetus taken from its mother and left to 
die in an operating room pail. Anyone 
who believes in abortion, especially 
for purely selfish reasons, is someone 
less than human. 

Why not practice prevention, then 
the cure would never have to be discuss- 
ed? 

If the laws on abortion become so 
permissive, just how far off is euthan- 
asia? — K.F. VanDeSype, Reg. N., 
Radville, Saskatchewan. 

With few exceptions, the views of ed- 
ucated and intelligent women on the 
subject of abortion seem to be ac- 
ceptance. The views that are getting 
into print have almost all agreed: (a) 
that abortion is not a crime and should 
therefore be removed from the criminal 
code; (b) that in the early stages the 
fertilized ovum is simply "undifferen- 
tiated tissue" — hence nothing human 
is being killed by an abortion; (c) that 
the prospective mother should always 
come first, that her wishes should be 
paramount. 

Is abortion, if legalized, going to 
become the convenient solution to 
irresponsible behavior in this coun- 
try? Probably it is; almost all the res- 
pected and knowledgeable voices are 
supporting its legalization. 

If we put all the effort spent clamor- 
ing for "free abortions on demand" 
into educating our young people, and 
into providing free sterilization for 
women who don't wish to have more 
or any children, would we not succeed 
in solving the problem of the unwanted 
pregnancy without resorting to murder? 
— S.E. Smith, R.N. Winnipeg, Man. 



It seems strange to me that The Ca- 
nadian Nurse always comes down on the 
"liberal" side of the fence. This trend 
was evident in the fluoridation contro- 
versy and the narcotics problem. Now 
we nurses are being brainwashed into 
a Women's Lib philosophy on abor- 
tion (Feb. '7 1 issue). 

I am surprised that we are expected 
to swallow this emotional line rather 
than be offered a professional, statisti- 
cal, moral, and economic argument. 
The Planned Parenthood organization. 



K 


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APRIL 1971 



THE CANADIAN NURSE 



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The Posey Pelvic Seat effectively 
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6 THE CANADIAN NURSE 



(Continued fn>m pn^e 5) 



in a 1963 pamphlet, stated: "An abor- 
tion requires an operation. It kills the 
life of the baby after it has begun." 
That this adds up to murder has been 
proven in a number of court cases. 

Japan is currently considering 
changing its abortion laws because of 
its 2.5 million abortions per year and 
the highest suicide rate in the world of 
women in child-bearing age (see 1965 
report on U.N. -sponsored World 
Population Conference held in Bel- 
grade, Yugoslavia.) 

Throughout the world, legislation 
to protect the "health of the mother" 
may quickly be interpreted as the "well- 
being" of the mother — or someone 
who wants to avoid disruption of her 
social life, or the inconvenience of 
being unable to wear the latest mod 
fashions. 

I do not believe in lending my serv- 
ices to this slaughter-house butchery 
of human life. Quite frankly I defy any 
nurse who has taken part in an abor- 
tion on a six-weeks old fetus to deny 
that the fetus is almost fully formed. 
Personally, I would sooner turn my 
back and sling hash for a living. — 
Jocelyn Schibild, R.N., West Vancou- 
ver, B.C. 

A registered nurse stated in the De- 
cember issue of The Canadian Nurse 
that to refuse abortion to a woman is 
the same as refusing to treat a woman 
injured in an auto accident. When a 
woman gets pregnant and does not 
want the child, a nurse would treat her, 
counsel her, and help her to accept the 
fact; a nurse would also treat the 
wound, the mind, the whole person 
if a woman were involved in an acci- 
dent. They are both injured and we 
must help each person in her need. 

Abortion is certainly not the answer. 
Human life is sacred. God is the author 
of life, and that life is under His do- 
main, not that of society, the state, or 
an individual mother. Who has the 
right to pass a death sentence on a 
totally mnocent being who possesses, 
at least potentially, all the attributes of 
human life? What is legal is not neces- 
sarily moral. 

Reasons advocated for taking life 
by legal abortions .are flimsy: 1 . Be- 
cause a mother does not want the child. 
There are many children already born 
who are not wanted. Have we the right 
to kill them? Society must be con- 
cerned and help with education. 2. 
Because deformity is feared. Are we 

APRIL 1971 



icertain the child is going to be deform- 
ed? Why kill it before it is born? There 
are many handicapped who are happy 
and useful citizens; besides they are 
human beings who have the right to 
live. 3. Because a stigma is attached to 
unwed motherhood. Why should there 
be a stigma? Somehow this suggests 
that a child about to be born out of 
wedlock has no right to live. This is 
an anti-social, heartless attitude. Rather 
than an abortion, the unwed mother- 
to-be needs love, acceptance, considera- 
tion, and someone to understand her 
deep emotional problem and to care 
for her. 

Vatican II, in its Modern World, 
summed up the Christian tenet: "From 
the moment of conception life must 
be regarded with the greatest care, 
while abortion and infanticide are un- 
speakable crimes." — Sister A. Hewko, 
Trochu, Alberta. 



Nurses on medical team 

It has been brought to our attention 
that throught the Health Care Insur- 
ance Plan, doctors in Alberta now have 
an average annual income of $46,000. 
Their offices are bulging, often with 
people who need only some health 
instruction and perhaps a cough mix- 
•ture or a prescription for a cold. 

Why can't the registered nurses' 
associations, the medical insurance 
boards, and the medical men cooperate 
to work out a less expensive system? 
Three or more registered nurses could 
work in every doctor's office to screen 
patients, do routine work such as a 
junior intern does, and take their fin- 
dings in to the doctor. At $3 an hour, 
which is more than most nurses are 
getting, the cost of office visits could be 
cut down to a more realistic figure, 
really sick patients could get more of 
the doctor's time, and no one would 
wait three hours in a waiting room. 

You only have to look in the em- 
ployment section of The Canadian 
Nurse to see that the employment sit- 
uation is grim. This system would 
increase the number of positions avail- 
able, and it might improve the nurse 
image as something more than a "yes" 
girl for doctors. Nurses are natural 
teachers, and as they do their work in 
this screening situation, they could 
give some instruction in preventive 
medicine. 

Registered nurses' associations in- 
crease their fees, but they give nurses 
very little service. When you consider 
that many nurses spend as much time 
as doctors to get their degree, yet earn 
a starting salary of only one-sixth of the 
medical men's average in Alberta, there 
is something wrong with our public 
relations department. 
APRIL 1971 



I hope some of our voting delegates 
to the Canadian Nurses' Association 
annual meeting will try to do some- 
thing to make nurses a part of a medical 
team in our health insurance plan. 
— Nora B. Reilly, R.N., Edmonton, 
Alberta. 

Prevention of congenital rubella 

Winnifred Raid's article on "Congen- 
ital Rubella" in the January 1971 edi- 
tion of The Canadian Nurse, is of 
interest to us at University Hospital 
in Saskatoon, Saskatchewan. We are 
carrying on a similar program where- 
by all female staff of child-bearing 
age are tested to determine their anti- 
body level. Our program began Novem- 
ber 1969, and since then 1,280 blood 
samples have been taken. Our data indi- 
cate 8.5 percent have no immunity. 

Included in the statistics were ap- 
proximately 20 reports of litres done 
on male residents and interns who were 
on pediatrics and obstetrical services 
when the program was initiated. 

Our employees are notified if they 
do not have immunity and they are 
advised to consult their physician about 
obtaining rubella vaccine. If an em- 
ployee does not wish to transfer from a 
susceptible area, leave of absence 
would be considered during the early 
part of pregnancy. 

The rubella titre program is under 
the direction of Dr. M. Bayatpour of 
the virology department in the laborato- 
ry. — C. Hnatiuk, R.N., Health Office 
Coordonator, University Hospital, 
Saskatoon, Sask. 



VON nurse applauds journal 

I enjoy the articles and even the nice 
magazine layout! I feel that it would 
be even better if more articles were 
printed about new medical develop- 
ments and their relevance to nursing. 

Being out in the patients homes as a 
VON, I sometimes feel that progress 
is leaving me behind, especially the 
aspects of acute hospital nursing. 

Your delightful magazine is just 
about the only way 1 have to 'keep 
abreast' and be informed in fields other 
than that in which I work. — Lauren 
Spilsbury, Coquitlam, B.C. ■§■ 



I GOOD THINGS | 
HAPPEN ' 

I WHEN YOU HELP | 

I RED CROSS I 



COLOMBIA, LATIN AMERICA 

Public Health nurses with experi- 
ence (rural experience an advan- 
tage) co-ordinate Public Health 
activities in the more remote areas 
of the country. The work involves 
administration, on-going teaching 
and supervision of auxiliaries spread 
over the state and interdisciplinary 
communication and co-ordination 
of all pubUc health activities. 

BScN {or RNs with teaching diplo- 
ma and/or experience) needed for 
teaching all subjects in schools for 
nursing auxiliaries. 
Head nurses (RNs with experience) 
and RNs general duty for all type 
of units - surgery, medicine, recov- 
ery, OR, pediatrics, OPD, CSR, 
intensive care. 

PAPUA AND NEW GUINEA, 
SOUTH PACIFIC 

BScNs (or RNs with diploma in 
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teaching staff terminates long-term 
contract in the summer of 1971. 

Wrile for full details of these and 
many other positions available in 
the fields of teaching, general duly, 
administration and public health. 
All CUSO assignments are for a 
minimum of two years. 



works 

ma . 

, word 

of peop e 

CUSO-1S1 Slater, Ottawa4. Ontario 



THE CANADIAN NURSE 




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news 



Nursing Research Committee 
To Develop Code Of Ethics 

Ottawa — Members of the special 
committee on nursing research, set up 
by the Canadian Nurses' Association, 
are interested in developing a code of 
ethics for nursing research. The com- 
mittee, at its first meeting held February 
19, decided to study the codes of other 
research groups prior to discussion at 
the next meeting planned for May 5 
and 6. 

Dr. Shirley Stinson, associate profes- 
sor, school of nursing, division of health 
services administration. University of 
Alberta, Edmonton, was elected chair- 
man. 

Along with discussion of the terms 
of reference at this first "exploratory" 
meeting, Pamela Poole, of the depart- 
ment of national health and welfare, 
spoke on national health grants, and 
Ann D. Nevill, on medlars. 

The committee was formed by the 
CNA board of directors at its October 
meeting, based on a recommendation 
of the CNA ad hoc committee on re- 
search, which reported to the board in 
June. 

The terms of reference of the com- 
mittee are: to assist the association to 
implement its evolving research policy; 
to make recommendations to the board 
regarding the association's role with 
respect to nursing research; to serve in 
a consultative and advisory capacity to 
the director, CNA research and advisory 
services; and to carry out such other 
activities related to research as may be 
assigned to it by the CNA board or 
referred by the CNA membership. 

Members of the committee are: 
Shirley Alcoe, school of nursing. Uni- 
versity of New Brunswick, Fredericton, 
N.B.; Dr. Moyra Allen, associate pro- 
fessor of nursing, school for graduate 
nurses, McGill University, Montreal, 
Quebec; Dr. Margaret C. Cahoon, 
professor and chairman of research, 
school of nursing. University of Toron- 
to, Toronto, Ont.; Sister Marie Simone 
Roach, acting chairman, department of 
nursing, St. Francis Xavier University, 
Antigonish, N.S.; Dr. Lucy D. Willis, 
director, school of nursing. University 
of Saskatchewan, Saskatoon, Sask.; 
Dr. M. Josephine Flaherty, of Toronto; 
Helen Glass of New York: Verna (Huff- 
man) Splane, principal nursing officer, 
office of the deputy minister, depart- 
ment of national health and welfare, 

APRIL 1971 



CNA Executive Director Appointed 
To Economic Council Of Canada 

Ottawa — A Canadian nurse. Dr. Helen K. Mussallem of Ottawa and Van- 
couver, is the first member of the health professions to be appointed to the 
Economic Council of Canada. The announcement of Dr. Mussallem's appoint- 
ment was made by the Prime Minister's office on Tuesday March 9, 197 1 . 

Dr. Mussallem, executive director of the Canadian Nurses' Association, 
joins two other eminent women, economists Dr. Sylvia Ostry and Dr. Beryl 
Plumptre, on the Council, which consists of three full-time members and 
twenty-five other members from all sectors of the economy and the various 
regions of Canada. 

The Economic Council was formed in 1963 as an independent body to 
combine the expertise of professional economists with the talent and experience 
of a broad spectrum of citizens from agriculture, labor, business, and the pro- 
fessions. Private merhbers play an active role with full-time staff in preparing 
the Council's annual reviews, which are intended to provide information and 
analysis to assist in decision making for both government and the private sector. 

Dr. Mussallem will attend the first Council meeting of her three-year ap- 
pointment on April 19 and 20 in Vancouver. 



Ottawa; Dr. Floris E. King, associate 
professor, school of nursing. University 
of British Columbia, Vancouver, B.C.; 
Rose Imai, CNA research officer; and 
E. Louise Miner, president of the Cana- 
dian Nurses' Association, (exofficio). 



Federal Government Answers 
Unemployment Insurance Concerns 

Ottawa — Nurses will contribute to, 
and be covered by, unemployment in- 
surance if the proposals contained in 
the federal government's white paper 
on unemployment insurance in the 
'70s are included in legislation expected 
to come into effect July 1 , 1 97 1 . 

David Weatherhead, chairman of 
the parliamentary standing committee 
on labor, manpower, and immigration, 
attended the November meeting of the 
social and economic welfare committee, 
Canadian Nurses' Association, to an- 
swer questions about the white paper. 

Two areas of concern developed: 
unemployed nurses referred to Canada 
Manpower Centers might be retrained 
into some other occupjition, such as 
clerical; or they might be required 
involuntarily to relocate to obtain a job. 
Letters were sent to Mr. Weatherhead's 
committee and to the minister of labor 
Bryce Mackasey, asking that further 
consideration be given to the implica- 
tions of referring professional em- 
ployees to Manpower Centers. 



In December, Peter Connolly, spe- 
cial assistant to the labor minister, wrote 
to CNA saying, in part, "it would only 
be in the most unusual circumstances 
that a member of the nursing profession 
would be asked to accept retraining in 
an area foreign to her interests and 
experience." He also said that "in the- 
case of professional workers the inten- 
tion is to update or improve existing 
skills within or closely related to their 
chosen field." 

The Weatherhead committee, in 
January, sent copies of its tlrst report 
on the white paper to the CNA pres- 
ident, the chairman of the CNA social 
and economic welfare committee, and 
the CNA legal advisor. 

In another letter to labor minister 
Mackasey, CNA said the association 
had been reassured by Mr. Connolly's 
comments about retraining, but is still 
concerned about possible involuntary 
geographic relocation. "For the nurse, 
who is a housewife and mother, this 
would be totally unacceptable." The 
letter also urged that "provision be 
made for a system of special exemp- 
tions from premium payments for em- 
ployees who would not under any cir- 
cumstances be able to benefit from the 
plan because they work only a few 
months each year." CNA also indicated 
its hopes "that the recommended coor- 
dination and co-operation will be evi- 
dent at all levels federally, provincially, 
and locally." 

THE CANADIAN NURSE 11 



(Continued from page 11) 



CNA received an answer in February 
from Mr. Connolly, who said, "The 
entire concept of the legislation has as 
its roots the goal of helping claimants, 
first in the form of cash, second with 
active assistance in finding a new job. 
You may be assured that the suggestion 
to relocate is made only after all other 
alternatives have been employed. On 
the other hand, if an unemployed person 
restricts her availability to the extent 
that it becomes impossible to find work, 
it would not be unreasonable to assume 
that she has removed herself from the 
labor market." 

Mr. Connolly also discussed the 
provision that would be helpful to 
nurses who work only during part of 
the year. "We propose to lower the 
entrance requirement to include those 
who have been in the labor force for a 
relatively short period of time — eight 
weeks during the preceding 52." 

After receiving the comments that 
retraining could mean upgrading, CNA 
wrote to the minister of manpower and 
immigration. Otto Lang, asking for 
changes in the adult occupational train- 
ing act to include provision for uni- 
versity courses. Mr. Lang has not yet 
replied to this letter, although he has 
indicated he will respond to the associa- 
tion's concern. 



United Nurses Of Montreal 
Begin Unique Training Program 

Montreal, P.Q. — An unusual train- 
ing program for its council repre- 
sentatives was initiated by the United 
Nurses of Montreal at the end of Feb- 
ruary, with the first of a series of week- 
end seminars held in a Laurentian 
resort hotel. 

The first seminar included 1 6 nurses 
from 12 hospitals and agencies, who 
met with the president of the United 
Nurses, Gloria Blaker, and two labor 
relations experts. The subject of the 
weekend seminar was the role of the 
council representative as related to her 
job, her communications with the 
membership, contract and grievances, 
and the committee on nursing. 

Beginning on a Friday night and 
running until Sunday evening, discus- 
sions, interspersed with films, included 
subjects such as "the challenge of 
leadership," "shop steward," "a case 
of insubordination," and "the griev- 
ance." Every issue that could arise 

12 THE CANADIAN NURSE 




The first of a series of seminars for council representatives of United Nurses In- 
corporated, formerly called the United Nurses of Montreal, was held at Far Hills 
Inn, Val Morm, Quebec, in February. Members from 12 hospitals and agencies 
met with their president and two labor experts to discuss union-management rela- 
tions and how to do their job effectively. In this photograph, labor expert Steve 
Wace explains a point to the group. 



in relations between nurses and ad- 
ministration was carefully developed, 
and the role of the council represent- 
ative in each situation was thoroughly 
discussed. 

A highlight of the seminar came 
when Gloria Blaker, assuming the 
role of the director of nursing in sim- 
ulating negotiations between union 
representatives and hospital adminis- 
tration, realistically posed some tricky 
points for the representatives to handle. 

Response of the council represent- 
atives was keen. At the conclusion 
of the seminar Sunday night, the UNM 
president said: "I am confident that 
if future seminars measure up to this 
one, council representatives will be 
able to play an important role in fight- 
ing for better working conditions for 
the nursing profession, thereby assur- 
ing better service for the general pub- 
lic." 

Future seminars in French and 
English are being scheduled to include 
all council representatives of the 38 
hospitals and agencies in which nurses 
are represented by the United Nurses 
of Montreal. 

An autonomous professional union 
that negotiates contracts with the gov- 
ernment of Quebec, the United Nurses 
of Montreal was formed in 1966 by 
the English Chapter, District XI, of 
the Association of Nurses of the Prov- 
ince of Quebec. 



ARNN And Government 
Meet On Wage Demands 

5/. John's, Nfld. — The Association of 
Registered Nurses of Newfoundland 
is meeting with representatives of the 
provincial government's treasury board 
to discuss increased salaries for nurses 
in the province, said Pauline Laracy, 
ARNN executive secretary. 

ARNN's executive committee and 
the provincial health minister Edward 
Roberts have decided on the negotiat- 
ing procedures to be followed. Jn a 
story in the St. John's Evening Tele- 
gram, Mr. Roberts said procedures 
were established at a meeting with the 
ARNN. In a release the ARNN said 
the negotiating process had been start- 
ed. 

At the association's annual meeting 
in October 1970, the 500 delegates 
unanimously approved a proposed 
salary recommendation which was for- 
warded in a brief to the government. 
The recommendation lists 25 categories 
of nursing, ranging from a minimum 
annual salary of $6,588 for a class orie 
nurse to $10,500 minimum annual 
salary for a nursing consultant. The 
current annual starting salary for a 
registered nurse in Newfoundland is 
$4,300. 

In a previous brief submitted to the 
minister of health in May 1970, the 

(Continued on page 14) 
APRIL 1971 



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(Continued from page 12) 

nurses called for a $100 monthly in- 
crease. The same month they rejected 
the government's offer of $45 per 
month. This general increase was of- 
fered to all government personnel. 

In July, the province's nurses voted 
in favor of a work slowdown, but a late 
settlement with the promise of conti- 
nued negotiations kept the 1 ,800 nurses 
on the job. The offer accepted included 
some fringe benefits along with the 
$45 monthly increase. Nurses later 
expressed dissatisfaction with the agree- 
ment and came up with the October 
recommendation. 

The ARNN will be among the first 
groups to negotiate with Newfound- 
land's newly formed board on collec- 
tive bargaining. 



University Nursing Students 
Hold Constitutional Conference 

Ottawa — More than 250 delegates, 
representing 22 university schools of 
nursing across the country, approved 
a draft constitution for the proposed 
Canadian University Nursing Students 
Association at a February Weekend 
conference. 

Hosted by students at the University 
of Ottawa School of Nursing, it was the 
fourth annual inter-university nursing 
conference. At last year's conference 
in Montreal students from the three 
attending universities, Ottawa, McGill 
and New Brunswick, proposed forming 
a national organization of university 
nursing students. Delegates from several 
universities held further discussions at 
the Canadian Nurses' Association June 
meeting in Fredericton, N.B. 

As objectives, the association in- 
tends to provide a communication link 
between nursing students in Canadian 
universities, to be a medium through 
whicl. students can express opinions 
on issues in nursing, to assist and initia- 
te research in the nursing field by using 
the skills of students, to promote liai- 
son with organizations concerned with 
nurses. 

The draft constitution includes rec- 
ommendations for a bilingual associa- 
tion with an annual meetmg ot the 
national executive followed by a con- 
ference for members, voluntary mem- 
bership open to students and registered 
nurses involved in nursing education 
programs throughout Canada. 

Before being adopted, the proposed 
constitution must be approved by dele- 
gates from participating universities at 
the 1972 conference to be held at the 
14 THE CANADIAN NURSE 




University nursing students "come together" at the conference for a proposed 
Canadian University Nursing Students" Association. Students from every prov- 
ince, representing 22 university schools of nursing, gathered at the University 
of Ottawa to get acquainted and to examine conference displays. 



University of Windsor, Windsor, On- 
tario. 

Guest speakers at this year's con- 
ference included: Dr. Beverly Du Gas, 
nursing consultant, health manpower 
studies section, health resources direc- 
torate, department of national health 
and welfare; Rose Imai, CNA research 
officer representing Dr. Helen Mussal- 
lem, CNA executive director; Eliza- 
beth Logan, director, school for gra- 
duate nurses, McGill University, re- 
presenting the Canadian Council of 
University Schools of Nursing; and 
Irma Riley, representing the Associa- 
tion of Nurses of the Province of Que- 
bec. 

Seminars were held dealing with the 
philosophy and objectives, the name 
and membership, administrative struc- 
ture, and financing. Conference coordi- 
nator was William Anticknap. Donna 
Mahoney, Joanna Emery, Peggy Borts, 
Joanne Hunter, Pat Allen and Rex 
Langman were committee heads. Carol 
Ann Godard was assistant coordinator, 
Mona Walrond, secretary, and Ann 
McFadden, treasurer. 



Nursing Education Committee 
Hearings Turn Controversial 

Fredericton, N.B. — Three issues 
turned hearings of a provincial study 
committee on nursing education into 
free-wheeling sessions of charge and 
countercharge. On one side there is the 
New Brunswick Association of Regis- 
tered Nurses with support from the 



University of New Brunswick faculty 
of nursing, some hospital schools of 
nursing and boards of trustees. On the 
other side is the New Brunswick Hospi- 
tal Association, other hospital boards 
and directors of nursing, doctors, ad- 
ministrators, mayors, a senator, an 
archdeacon, and concerned citizens. 

Controversial issue number one is 
the closing of hospital schools of nurs- 
ing; number two, the suggested phasing 
out of registered nursing assistant 
programs; number three is a challenge 
to the authority over the nursing profes- 
sion held by the NBARN. 

The NBARN has for some years 
urged the government to close hospital 
schools of nursing and to establish 
nursing education at the diploma level 
in institutions similar to junior colleges. 
In May, 1970, notifications were given 
to hospitals in Chatham, Newcastle, 
and Woodstock, that their hospital 
schools of nursing would no longer be 
accredited by NBARN. 

"A history of substandard condi- 
tions, precipitated by the termination 
of affiliation, led to the closing of the 
schools," said NBARN. Lack of satis- 
factory replacement for the pediatric 
affiliation was a major reason for 
NBARN's stand. It was also learned 
that obstetrical affiliation in Montreal 
will cease beginning September, 1971 . 

During the committee hearing in 
Newcastle, former health minister No- 
bert Theriault said he had been "shock- 
ed" when the NBARN failed to notify 
him of its decision to phase out the 

APRIL 1971 



three nursing schools. He said the 
NBARN has a responsibility not to 
close any schools of nursing until the 
provincial government decides what 
lines nursing education should take. 

In a prepared statement, the NBARN 
said it "takes exception to the remarks 
of the former minister of health. Mr. 
Theriault was well informed of the 
situation and was present at a meeting 
in March 1970, held to discuss these 
schools and their affiliation problems. 
Further meetings were held in June 
with the former minister following 
NBARN's May stand." 

In its appearance before the com- 
mittee, the New Brunswick Hospital 
Association said its view is "basically 
the same as that of the Canadian Hospi- 
tal Association — that hospital-based 
schools of nursing, providing an ac- 
ceptable education experience, must 
be retained and expanded." 

The challenge to the authority of 
NBARN came at the Woodstock hear- 
ings. The Carleton Memorial Hospital 
boards, whose school of nursing is 
being phased out because NBARN is 
withdrawing accreditation, said, "The 
provincial government must bear the 
responsibility for education of nurses. 
The NBARN, which is now responsible 
for training, curriculum, and standards, 
should only retain the right of setting 
the standard for admission to their 
association." 

The Carleton board also disagreed 
with NBARN over the abolition of 
nursing assistants. The board said nurs- 
ing assistants will play an "increas- 
ingly important role" in such services 
as nursing homes and extended care 
facilities. 

A combined brief was presented to 
the study committee by the boards of 
directors of the Miramichi Hospital, 
Newcastle, and Hotel Dieu Hospital, 
Chatham. Both schools of nursing at 
these hospitals are being closed. The 
brief said, "The present situation is 
unacceptable, because the NBARN 
has the sole prerogative of denying 
graduates of a school of nursing the 
right to write registration examina- 
tions. We recommend that this pre- 
rogative be passed to the proper gov- 
ernment department with the NBARN 
retaining an advisory capacity." 

Other hospitals took a milder tone, 
suggesting regional schools of nursing 
be established. The Chaleur General 
Hospital, Bathurst, said, "Nursing 
should be within the main stream of 
general education, governed by a board 
of directors separate from hospital 
jurisdiction, although affiliated to a 
regional hospital." 

Dr. Helen K. Mussallem, executive 
director of the Canadian Nurses' As- 
sociation, visited Fredericton in early 
February on the invitation of NBARN. 
APRIL 1971 



"I went to consult with the NBARN 
representatives," she said. "My role 
was to provide the national picture. 
By giving the provinces this kind of 
information to analyze, they can deter- 
mine how to fit into the national trend." 

During a series of press conferences, 
radio and television interviews. Dr. 
Mussallem said, "It will only be a mat- 
ter of time in New Brunswick before 
the present diploma schools are phased 
into institutions under educational 
control. The plan put forward in 1960 
has now been implemented in various 
forms in most Canadian provinces. 
I didn't think it feasible that such great 
strides could be accomplished in a 
decade, but it has swept right across 
the country." 

The new health minister Paul Creag- 
han forecast changes in the province's 
nursing education system. "I feel the 
present approach is a little outdated. 
Whether this will mean the end of the 
hospital nursing school or not remains 
to be seen. I think we will have to wait 
until the committee gives us some sort 
of definite advice and perhaps a propos- 
ed plan or program." 

In defense of its position, the NBARN 
said, "We have been the only group 
to try to protect the patient and the 
student, yet the authority of the associa- 
tion to do this has been questioned. 



What advantage would there be in 
granting this authority to another group 
who has never been concerned with 
protecting these standards in the past? 

"It is unfortunate that this concern 
for excellence is only questioned when 
the association tries to delete some- 
thing that is substandard," the NBARN 
said. "The nurses' association has spent 
much time and money since 1916 in 
upgrading nursing service and educa- 
tion. The resources of the NBARN and 
the CNA will continue to be utilized 
in this effort," said the statement. 

Manitoba Seeks To Accredit 
All Health Facilities 

Winnipeg, Manitoba — A program 
under the joint-sponsorship of the 
medical, nursing, and hospital asso- 
ciations of Manitoba has been started 
with the aim of achieving standards 
of accreditation in the province's non- 
accredited health care facilities. 

The target date is March 31, 1973, 
for completion of the program as rec- 
ommended by the Canadian Council 
on Hospital Accreditation. 

J.G. Hayes is program administra- 
tor. He is director of counseling and 
education services tor the Manitoba 
Hospital Association, but will be work- 
ing full-time on the new project. 

(Continued on page 16) 




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THE CANADIAN NURSE 15 



news 



(Continued from page 15) 

NBARN Leaders Meet 
At Presidents' Conference 

Fredericton, N.-B. — Presidents and 
vice-presidents from the eleven chap- 
ters of the New Brunswick Association 
of Registered Nurses met at provincial 
headquarters for the association's an- 
nual presidents' conference held January 
21-22. The conference is held to assist 
present and future chapter presidents 
and to provide an opportunity for chap- 
ter leaders to discuss common prob- 
lems. 

Objectives of the conference were: 
to examine the different roles assumed 
by chapter presidents; to examine the 
responsibilities under each of these 
roles; to discuss the democratic pro- 
cess in relation to professional associa- 
tions and to relate these objectives to 
increasing the involvement of members 
in nursing affairs. 

Drug Symposium Recommends 
Community Clinics 

Montreal, P.Q. — A system of com- 
munity clinics to treat drug users was 
advocated by Health Minister John 
Munro at a national symposium held 
in February. Later, participants at the 
Montreal symposium, including nurses, 
physicians, paramedical personnel, 
administrators, and members of the 
young generation recommended such 
clinics be coordinated with traditional 
health institutions. 

The symposium on hospital respon- 
sibility toward drug users was spon- 
sored by the Canadian Hospital Asso- 
ciation with the support of the depart- 
ment of national health and welfare. 

Mr. Munro said that hospitals evolve 
too slowly compared to the problems 
which have to be met. He said drug 
users must receive not only emergency 
treatment but must also be given at- 
tention, free of "red tape," from a 
multidisciplinary team in a position 
to meet their psychological, social, 
and medical needs. These emergency 
drug centers must be set up at the 
regional level in a spirit of community 
assistance, said the minister. 

The symposium's main objective 
was to help hospitals develop efficient 
programs for short- and long-term 
treatment of drug users. Measures 
suggested were: 

• induce positive attitudes and behavior 
among hospital personnel who come 
into contact with drug users. 

• determine standards of installations 
and management of personnel in charge 
16 THE CANADIAN NURSE 



of admission, evaluation, and emer- 
gency treatment of patients. 

• determine guidelines for long term 
treatment and rehabilitation of patients. 

• promote information and participa- 
tion of volunteers. 

• encourage and stimulate programs at 
the regional level. 

One speaker. Dr. John Unwin, psy- 
chiatrist and director of youth serv- 
ices, McGill University, Montreal, 
said the hospitals' reaction to the drug 
problem should make us feel ashamed. 
The few efforts made to help drug users 
were made by non-hospital organiza- 
tions, he said. 

Dr. Unwin said some hospitals re- 
fuse to admit narcotic patients in need 
of care. They are more concerned about 
the moral repercussions of drugs than 
about drug users. They are more in- 
clined to theology than to therapy, he 
added. It is time they act positively. 

Having their say at the symposium, 
young people cited doctors for their 
lack of information about drugs. They 
felt they knew more about drugs than 
doctors do. Community clinics are the 
only organizations that succeed in 
reaching victims of drug abuse, they 
said. 

They suggested that doctors, instead 
of trying to decide whether marijuana 
is good or not, should get busy treating 
heroin, LSD, and mescaline users. 

Dr. Aurele Beaulnes of the federal 
department of health and welfare out: 
lined the government's program to 
fight the use of drugs for non-medical 
purposes. Based on the recommenda- 
tions of the preliminary LeDain Re- 
port, the government will invest 4.6 
million dollars in research, information, 
treatment, and laboratories. 



Some research will be undertaken 
jointly by the national department 
of health and welfare and the medical 
research council. The program, to be 
set up in consultation with provincial 
health departments, will include gather- 
ing, analysis, and sharing of data. One 
priority item is the establishment of 
regional laboratories for toxicology 
analysis. 

The government will make funds 
available for research into social prob- 
lems resulting from drug abuse. One 
subject to be investigated will be the 
factors inducing individuals to abuse 
drugs. Grants will be awarded for pilot 
projects and other types of short-term 
help as well as research programs un- 
dertaken by existing or new organiza- 
tions. Some new organizations to be set 
up will be administered by young peo- 
ple. 

The symposium ended by adopting 
20 resolutions. Some of them are: that 
the Government of Canada delay im- 
mediately the penalties to persons in 
possession of cannabis; that health 
centers secure the assistance of tox- 
icomania specialists; that the govern- 
ment be' more rigid regarding the 
production, import, and distribution 
of prescription drugs. 

Dr. Helen K. Mussallem, executive 
director of the Canadian Nurses' As- 
sociation, chaired one of the panel ses- 
sions at the conference. She said it was 
difficult to describe the impact the 
conference made on her. 

"I was made aware for the first time 
that drug users were considered the 
modern leper. The drug users have 
been rejected by hospital and established 
health care centers. The growth of 
street clinics and drop-in centers show 



CARDIAC COMMENTS: 

By Patricia Orr, R.N., 

New Brunswick 




'I Wonder What He Thinks He's Doing Back Again! 



APRIL 1971 



what happens when existing institu- 
tions don't meet a need — then, some- 
thing else happens. 

"It really came through at the con- 
ference that there needs to be some way 
to reach people requiring the kind of 
help needed by drug users. Once again 
we see the manifestations of breakdown 
in the health care delivery system. A 
great gap exists (in what I call the 
health care non-system) between the 
ever-increasing scientific and medical 
knowledge and the people who need 
help," said Dr. Mussallem. 

"But I was inspired by the way 
young people set up a network of 
drop-in clinics. To hear from the young 
nurses and doctors — looking like 
hippies themselves — who work in the 
front lines with this problem was most 
exciting to me," she said. 

MARN Surveys 
Employment Scene 

Winnipeg, Man. — The Manitoba 
Association of Registered Nurses is 
conducting a survey of the employment 
situation for nurses in Manitoba. 

To complete the survey all nurses 
who have recently sought employment 
and were unable to secure a position, 
are asked to contact MARN, 647 
Broadway Avenue, Winnipeg 1, Mani- 
toba. 

Provincial Monies Support 
Intermediate Care Program 

Vancouver, B.C. — Approval by the 
British Columbia legislature of a 
$500,000 spending estimate for the 
development of alternative health care 
facilities is regarded as a step in the 
right direction by the Registered 
Nurses' Association of British Colum- 
bia, who had urged this kind of care 
be given priority. 

Monica Angus, RNABC president, 
said, "We have been advocating the 
provision of home care services and the 
establishment of intermediate care 
facilities as necessary to a compre- 
hensive health care delivery system. 
We will be interested in learning pre- 
cisely how the government plans to 
implement these programs." 

The RNABC is hopeful the proposed 
home care program will include ade- 
quate supportive services by nurses, 
social workers, and physiotherapists, 
as well as back-up services. Mrs. Angus 
said the proposed intermediate care 
facilities would free acute care hospitals 
and extended care facilities from hous- 
ing persons who do not need these more 
expensive services. 

The association had reacted strongly 
following a February statement by 
provincial health minister Ralph Loff- 
mark that the provincial government 
was not prepared to extend hospital 

APRIL 1971 



insurance to cover such intermediate 
care. At that time Mrs. Angus said, 
"We believe the people needing this 
type of care are the least able of all 
public groups to exert influence in 
health care decisions. 

"The need is evident for some facility 
where nursing care can be given for 
rehabilitative and long-term patients," 
she said. "The needs of active wage- 
earning persons are relatively well met 
but the needs of the elderly, the infirm, 
and the disadvantaged are not." 



Family Planning Conference 
Discusses Federal Program 

Ottawa — An informal two-day con- 
ference was held in February to discuss 
the department of national health and 
welfare's proposed program to make 
family planning information and serv- 
ices available to interested citizens. 
Representatives of national agencies 
active in family planning programs 
attended the conference along with 
government officials. 

Catherine MacGregor, supervisor, 
family planning clinic, Ottawa-Carle- 
ton regional area health unit, repre- 
sented the Canadian Nurses' Associa- 
tion. Also represented at the meeting 
were the Canadian Medical Associa- 
tion, the Canadian Association of 
Social workers, le Centre de planning 
familial du Quebec, the Family Plan- 
ning Federation of Canada, and the 
International Planned Parenthood 
Federation. 

Health Minister John Munro said 
the federal program will focus on re- 
ducing the incidence of unwanted 
children, of child neglect, abandon- 
ment, desertion, welfare dependency, 
and child abuse. Infant mortality is a 
prime concern of the program. The 
minister indicated that his department 
officials will meet with provincial 
government health and welfare of- 
ficials to discuss the program, which 
will operate in cooperation with the 
provinces. 



MARN Plans 
Citizenship Ceremony 

Winnipeg, Manitoba — The Manitoba 
Association of Registered Nurses is 
planning a special citizenship ceremony 
for May 12, 1971, in the new Victoria 
General Hospital, Winnipeg. The cere- 
mony, to be held on the anniversary 
of the birth of Florence Nightingale, 
will be for nurses who are not yet Ca- 
nadian citizens and who want to obtain 
their citizenship during 1971. 

Arrangements are being made by 
the Citizenship Court in Winnipeg 
through the cooperation of the Court 
of Canadian Citizenship. 




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THE CANADIAN NURSE 17 




American Nurses March 
To Support Nursing Bill 

Albany. New York — Busloads of 
nurses from every area of New York 
state and from every occupational set- 
ting, marched on the state capital, Al- 
bany, in support of a bill which seeks 
to update the present definition of nurs- 
ing written in 1938. 



Now pendmg before the legislature, 
the bill, known as the Laverne-Pisani 
bill, calls for the recognition of the 
distinct and independent role of the 
nurse in such areas as casefinding, 
health teaching, health counseling, 
and provision of supportive nursing 
care services. Approval of the new 
definition is seen as essential to the 
nursing profession's efforts to main- 
tain its traditional role as the patient's 
assistant and guarantor of the delivery 
of adequate nursing care services. 

Supfxjrters of the bill believe lack 
of understanding of the independent 




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It takes but a moment to identify your pa- 
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Ident-A-Band. Then just a glance is all you'll 
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18 THE CANADIAN NURSE 



role of nursing poses a serious threat to 
the profession. They viewed the march 
as a statement of solidarity from nurses 
and reaffirmation of their commitment 
to the patient. The rally, held on March 
2, united both registered and practical 
nurses under a banner, "nurses for the 
preservation of nursing." 

Nurses not able to attend the march 
supported its spirit by calling or writing 
members of the legislature. The New 
York State Nurses' Association coordi- 
nated the march. 

McMaster School Studies 
Role Of "GP's Nurse" 

Hamilton, Ont. — A nurse in a gener- 
al practitioner's office may be any- 
thing from a glorified receptionist to a 
medical assistant who makes house 
and hospital visits and does counseling 
and physical examinations. 

A story in the Hamilton Spectator 
said the patterns in the Hamilton area 
will be studied by the McMaster school 
of nursing with the first grant it has 
received for research. 

The school has an $8,380 national 
health grant for the first part of a 
$25,000 study that will cover 50 doc- 
tors' offices in the area, and is expected 
to continue until next tall. 

May Yoshida, a nurse with additional 
training in sociology, will direct much 
of the fact-finding, which includes fol- 
lowing nurses around for a day, and 
questionnaires for nurse, doctor and 
receptionist. About 10 patients from 
every doctor's practice will be asked 
their attitudes and expectations about 
who does what for them in health care. 

Dr. Dorothy J. Kergin, director of the 
school of nursing, said one of the basic 
reasons for the survey is educational 
planning. 

"We want to see if there is a need for 
a continuing education program for 
nurses in doctors' offices to give them 
additional skills. We also want to know 
if the basic education program should 
be changed to equip a nurse to assume 
wider responsibilities." 

But the Spectator story said the study 
has wider implications. There is much 
concern currently, by both govern- 
ment and the medical professions, about 
rising health care costs. Use of people 
other than doctors for some areas of 
health care is often suggested as one 
way of both cutting costs and making 
better use of a limited supply of MDs. 

Many see the nurse as the obvious 
person to take over some of these du- 
ties, and some suggest she should be 
given a new title, such as nurse prac- 
titioner, doctor's assistant, or doctor's 
associate. 

The Canadian nursing profession 
maintains there isn't a need for a fancy 

{Continued on piific 20) 
APRIL 1971 



EXPAND YOUR PERSONAL LIBRARY 



1. NURSING OF PEOPLE WITH CARDIOVASCULAR PROBLEMS. 

By Sister Catherine Armington, D.C., R.N., B.S.N.E., and Helen 
Creighton, R.N., A.M., M.S.N., J.D. Approx. 350 pp., illustrated. 
In preparation. 

This new book provides the nurse with what omounts to a post- 
graduate course in the care of patients with cardiovascular prob- 
lems. Prepared with the needs of both patient and nurse in mind, 
this volume has been enriched by the advice and suggestions of 
various cardiologists, cardiac surgeons, end nurse educators. 

2. NURSING CARE OF CHILDREN 

Eighth Edition. Florence G. Bloke, R.N., M.A., F. Howell Wright, 
M.D., and Eugenia H. Waechter, R.N.. Ph.D. 588 pp. 254 illus- 
trations. 1970. $9.50. 

Completed revised and expanded, with an entirely new format and 
many new illustrations, this superb text is without peer as a com- 
prehensive, in-depth study of pediatric nursing. It is organized 
according to age groups, from infancy to adolescence. Increased 
emphasis is placed on growth and development at each age period. 

3. NURSING CARE OF THE LONG-TERM PATIENT 

Second Edition. Jeanne E. Blumberg, R.N., P.H.N. , M.S.; and Eleanor 
E. Drummond, R.N., P.H.N., Ed. D. 1970. 288 pp. $3.95. 

Expanded edition of this successful book, largely rewritten end its 
scope broadened by a new emphasis on the interrelatedness of eight 
key concepts and by discussion of new techniques and procedures. 

4. TEXTBOOK OF MEDICAL-SURGICAL NURSING 

Second Edition. Lillian Sholtis Brunner, R.N., M.S., Charles Phillips 
Emerson, Jr., M.D., L. Kraeer Ferguson, M.D., F.A.C.S., and Doris 
Smith Suddarth, R.N., M.S.N., with a Panel of Contributors. 1031 
pp. 387 Illustrations. 1970. $14.95. 

Massively revised and enlarged in scope, this edition is designed 
to develop the highest degree of clinical expertise in the care of 
medical and surgical patients. Outstanding in its depth of patho- 
physiologic content, the text also emphasizes the psychosocial factors 
involved in patient care. 

5. NEW DIRECTIONS FOR NURSES 

Selected readings. By Bonnie Bullough, R.N., Ph.D.; and Vern 
Bullough, PhD., 1970. 386 pp. $5.25. 

What's ahead for the nurse who is serious about her, or his profes- 
sion? Here, in 40 timely articles assembled by the editors of Issues 
in Nursing, are the highlights concerning expansion of the nursing 
role and the various nursing and paramedical specialties now em- 
erging; the changing nurse-doctor telationship; inequities in health 
care and their meaning for the nurse; the crisis in manpower — 
what accounts for the shortage and how can it be overcome? 

6. DUNCAN'S DICTIONARY FOR NURSES 

Helen A. Duncan, R.N. 1971. 408 pp. $5.25; hardcover $7.95. 

All the terms a modern professional nurse needs to know in nursing, 
medicine, psychiatry, the social and biological sciences — more than 
10,000 entries, compiled for nurses, by a nurse. 



7. MATERNITY NURSING 



New Edition 



Twelfth Edition. Elise Fitzpatrick, R.N., M.A., Sharon R. Reeder, 
R.N., M.S., and Luigi Mastroianni, Jr., M.D., F.A.C.S., F.A.C.O.G. 
Approx. 700 pp. 320 Illustrations. Spring 1971. $9.75. 



Maintaining the same high goals of earlier editions, this family- 
focussed textbook is directed toward the total health and well-being 
of the mother and infant. Expanded and updated in line with new 
medical concepts and concomitant nursing practice, this is com- 
prehensive maternity nursing at its best. 

The importance of psychosocial factors is reflected in the authors' 
decision to integrate psychological principles throughout the text 
and add an entirely new chapter on Social Factors. New chapters 
also include Patient Teaching and Fetal Diagnosis and Treatment. 
A number of illustrations and diagrams have been added to aid 
student comprehension. A new author joins the book with this 
edition. Dr. Mostroianni has a distinguished background in teaching 
research and clinical practice. 

8. DRUGS IN CURRENT USE AND NEW DRUGS 1971 
Walter Modell, M.D. 184 pp. $3.95. 

Annual standby for nurses. Now even further improved, with the 
section on FDA requirements for new drugs considerably stream- 
lined, making it more precisely applicable to the nurse's needs. 

9. PEDIATRIC SURGERY FOR NURSES 

Edited by John G. Raffensperger, M.D., and Rosellen B. Primrose, 
R.N., B.S. Illustrated. 327 pp. 1968. $11.00. 

Students and pediatric nurses will find this text straightforward, 
easy-to-use, and essential as a guidebook for handling pediatric 
surgical patients Detailed descriptions of patient conditions and 
di-scussions of preoperative and postoperative care appear throughout 
the book. Included also are many useful photographs illustrating 
surgical procedures and patient syndromes. Authoritative advice on 
the many psychological considerations in dealing with a sick child 
and his parents adds to the depth of this recommended text. 

10. NURSING IN THE CORONARY CARE UNIT 

LaVaughn Sharp, R.N., M.A., and Beatrice Robin, R.N. 213 pp. 
89 Illustrations. 1970. $8.25. 

Concrsely written by well-qualified authors and amply illustrated 
with graphs and charts, this book guides the nurse in making de- 
cisions and initiating appropriate measures for optimum care of the 
coronary patient. Content covers diagnostic measures, including 
interpretation of the oscilloscope and other electronic monitoring 
equipment, etiology, treatment, psychological support, and nursing 
intervention for all types of coronary artery disease. 

11. DETERMINANTS OF THE NURSE-PATIENT RELATIONSHIP. 

By Gertrud Bertrand Ujhely, R.N., M.A., 1968. Flexible Coyer, 
283 pp. $4.25. 

A highly successful, three-part exposition of recurrent variables — 
in nurse, patient, and setting — that makes it easy for the nurse 
to adapt the basic demonstrations from the book to specific 
nurse-patient situations. 

12. INTERPRETATION OF DIAGNOSTIC TESTS 
By Jacques Wallach, M.D. 450 pp. 1970. $7.50. 

The value of this compact book is immeasurable. The clinician can 
use it quickly and efficiently as an aid in choosing the most useful 
laboratory test or in interpreting abnormal laboratory reports. The 
three major sections include a tabulation of normal values, labo- 
ratory findings on the most important diseases (including many only 
recently described), and deliniation of abnormal test results and the 
diseases associated with them. The many tables and graphs, emphasis 
on sequential time changes in diseases, and differential diagnosis of 
common but perplexing medical problems make this a most con- 
venient source of facts for the clinician. 



PLEASE SEND ME THE BOOKS I HAVE CIRCLED BELOW _ 

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APRIL 1971 




THE CANADIAN NURSE 19 




(Coiuimied from page 18) 

new title — even with an expanded 
role, the nurse should still be called just 
that. 

Will doctors give up some of the 
things they have traditionally done? 
Will patients accept care from a nurse, 
particularly in an era when they have 
insurance that supposedly guarantees 
them the attention of a doctor? Do 
nurses themselves want these additional 
duties and responsibilities? Dr. Ker- 
gin pointed out that the United States' 
experience, which is taking some of the 
load off doctors, isn't too useful to 
Canadian situations. 

So, built into the Hamilton area 
survey will be questions that will reveal 
some of the attitudes toward a new role 
for the nurse employed by the general 
practitioner. 



Nurses Study 
Remotivation Therapy 

Verdun, P.Q. — Hospital personnel 
from eastern Canada and the United 
States have been attending workshop- 
training sessions in remotivation thera- 
py at Douglas Hospital, Verdun, one 
of Canada's most active centers for this 
type of training and therapy. 

Peter Steibelt, director of remotiva- 
tion, who started the formal program 
at the hospital in 1966, conducts the 
five-day course of lectures, practice, 
and workshop training. Usual atten- 
dance is between 40 to 60 volunteers 
and staff members of other hospitals. 

The techniques, designed to help 
patients return to reality, consist of 
group discussion of concrete subjects. 
Eight hundred mental patients partici- 
pate in the 70 regular remotivation 
groups within the hospital. There are 
basic steps followed by the remotiva- 
tors or leaders in helping patients build 
a "bridge to reality" and develop in- 
terest and appreciation of everyday 
life. 

Leaders evaluate the members of 
their group at the beginning and end of 
the 12-week sessions, on such points 
as, "interest, participation, compre- 
hension, knowledge, speech, grooming, 
and language." The hospital's remotiva- 
tion council' meets regularly with rep- 
resentatives of medical, nursing, social 
service, and occupational therapy 
departments to report progress, ex- 
change opinion, and discuss possibili- 
ties of further rehabilitation. 

Initially the average long-term re- 
gressed patient was considered the 

20 THE CANADIAN NURSE 



prime prospect for remotivation ther- 
apy. Now all types of patients, includ- 
ing those with much better contact with 
reality and pre-discharge groups, are 
treated. 



School Nurses Take 
Practitioner Course 

New York, N. Y. — An experimental 
program to prepare school nurse prac- 
titioners was started by the University 
of Colorado, Denver, Colorado, re- 
ports the November 1970 issue of the 
American Journal of Nursing. 

The experiment began with four 
public school nurses in September. 
When they have finished the course 
they will be qualified to assume the 
responsibility for identification and 
management of many child health prob- 
lems with assistance from physicians 
as needed. The nurses will assess psy- 
chological, neurological, nutritional, 
or other problems affecting normal 
development, behavior and ability to 
learn. 

They will take medical histories, 
do physical examinations, and super- 
vise screening tests to detect and to 
evaluate evidence of acute or chronic 
disorders affecting speech, sight, hear- 
ing, and posture. They will do immu- 
nizations, give direct treatment for such 
common illnesses as mild upper respir- 
atory infections and skin rashes, and 
give emergency care. 

The course was developed by Henry 
K. Silver, professor of pediatrics at 
the University's school of medicine. 
He is co-author with Loretta P. Ford, 
professor of community health nurs- 
ing in the CU nursing school, of the 
pediatric nurse program. 

A second class of selected nurses 
began the course in January. The course 
is open to experienced school nurses 
who hold a bachelor's degree. Thirty 
nurses are expected to be trained during 
the three-year experiment. 

The course is jointly sponsored by 
the CU schools of medicine and nurs- 
ing and the Denver public schools. It 
is funded by grants of $84,540 from 
the Commonwealth Fund, New York, 
and $50,000 from the Bruner Foun- 
dation, New York. 



US Nurses Like 
Short Work Week 

New York, N.Y. — American indus- 
try's latest trend is the shorter week, 
longer working day plan. The Novem- 
ber 1970 issue of the American Jour- 
nal of Nursing, describes how a hos- 
pital in Providence, Rhode Island, 
used such a plan in setting up a new 
shift schedule for its nurses. 

The nurses in each unit are divided 
into two teams, with one tearn working 



while the other is off. Each team works 
seven 10-hour days every two weeks. 
The first week's schedule is Sunday, 
Wednesday and Thursday. The second 
week is Monday, Tuesday, Friday, 
and Saturday. Each 24-hour period 
is divided into two 10-hour shifts and 
one 5-hour shift: 7:00 A.M. to 5:00 
P.M.; 5:00 P.M. to 10:00 p.m.; and 
9:00 P.M. to 7:00 A.M. 

The schedule of 70 working hours 
is spread over seven working days 
each two weeks. There are four days 
of work one week and three the alter- 
nate week for an average of three and 
one-half working days a week. The 
nurses are paid the same rate they 
received when they worked 40 hours 
over the traditional five-day week. 

This plan was developed as a way 
to allocate nursing personnel more 
evenly over the 24 hours and seven 
days a week that hospitals have to 
staff. The former schedule for a 5 -day, 
40-hour week, combined with a policy 
of alternate weekends off for all nurses, 
caused inflexibility in scheduling, too 
much overstaffing, and too high a ratio 
of part-time to full-time nurses, said 
the administration. 

The hospital was having difficulty 
getting and keeping full-time nurses, 
and had a majority of part-time nurses 
on its staff. The administration was 
concerned about the effect this situa- 
tion might have on patient care as the 
use of more part-time nurses caused 
more shift changes and more transfer- 
ring of information about patients from 
one nurse to another. 

The new system was started more 
than a year ago in the coronary care 
unit of the 267-bed general teaching 
hospital. It was enthusiastically accept- 
ed by the nurses and was offered to 
other nursing units on a voluntary basis. 
At present, 300 of the 350 nurses con- 
sidered eligible for the schedule are on 
it. Some units, such as the operating 
room, were never staffed full-time 
seven days a week. 

The nurses like having two or more 
days off consecutively, alternating 
three-day weekends, and less time spent 
per year traveling to and from work. 
The administration said the system 
decreased overstaffing, helped recruit- 
ment, provided more efficient patient 
care, and pleased the nurses. 



Manitoba Board Refuses 
To Certify Winnipeg Group 

Winnipeg, Man. — The Winnipeg Gen- 
eral Hospital Registered Nurses' As- 
sociation's application for certifica- 
tion as a collective bargaining group 
was turned down by the Manitoba 
labor board. The dismissal by the 

(Continued on page 23) 
APRIL 1971 




NOWAY! 



There's no way airborne contaminants can accidentally get into 
viAFLEx plastic containers unless you inject them. Unlike glass 
bottles, the VIAFLEX container has no vent — room air is kept out. 
It's the only completely closed I.V. system; airborne contami- 
nants are locked out. and the system remains sterile throughout 
the procedure. Even when the spike of the set is inserted, air 
cannot get in — because the spike completely occludes the port 



opening before it punctures the Internal safety seal. A self- 
sealing latex cap on the second port is provided fo r adding 
supplemental medication, viaflex is the first and 
only plastic container for intravenous solutions. ^™ j(»- 
To assure your patient the safety of a completely 
closed system, it's the first and only container 
you should consider. 




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Fleet — the 40-second Enema* — is pre-lubricated, pre-mixed, 
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Ordeal by enema-can is over! 

Quick, clean, modern, FLEET ENEMA will save you an average of 
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WARNING: Not to be used when nausea, 
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Frequent or prolonged use may result in 
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CAUTION: DO NOT ADMINISTER 
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OF AGE EXCEPT ON THE ADVICE 
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In dehydrated or debilitated 
patients, the volume must be carefully 
determined since the solution is hypertonic 
and may lead to further dehydration. Care 
should also be taken to ensure that the 
contents of the bowel are expelled after 
administration. Repeated administration 
at short intervals should be avoided. 



22 THE CANADIAN NURSE 



Full information on request. 

■Kehlmann, W. H.: Mod. Hosp. 84:104, 1955 

FLEET ENEMA® — single-dose disposable unit 



/ ^— ^^ QUALITY PHARMACEUTICALS 

' ft;^ CAanfedCJia^a &Ca 

*^-^^ R«KL*NO (MONTfltAli CANADA j 



APRIL 1971 



news 



(Coiiliniicd from pane 20l 



board denies the group the right to 
bargain collectively. 

The provincial staff nurses' coun- 
cil of the Manitoba Association of 
Registered Nurses is "appalled'" at the 
decision. The council and the hospital 
group are meeting to decide on future 
courses of action. 

Six bargaining units already cer- 
tified by the labor board are composed 
exclusively of registered nurses. These 
represent nurses at Brandon General 
Hospital, Assiniboine Hospital, St. 
Boniface General Hospital, Misericor- 
dia General Hospital, Victoria General 
Hospital, and the Winnipeg Civic 
Nurses' Association. 



TV Panelist Named 
A Medical Watchdog 

Toronto, Out. — Betty Kennedy, well- 
known as a panelist on "Front Page 
Challenge," a CBC weekly TV show, 
was appointed in January to the com- 
plaints committee of the College of 
Physicians and Surgeons of Ontario by 
health minister Thomas Wells. 

Mr. Wells said this was the first time 
a member of the public, except for 
health ministers who are sometimes not 
doctors, will participate in the college's 
activities. 

Dr. J.C. Dawson, the college's regis- 
trar, said the college asked that a non- 
medical person be appointed to its 
complaints committee after some just- 
ifiable dissatisfaction had been express- 
ed about the way patients' complaints 
were handled. 

During a six-month period ending 
October 31, 1970, the college received 
104 complaints in writing and about 
300 by telephone. Most complaints 
were settled by the college's staff, but 
12 were sent to the complaints commit- 
tee. Of these, three were dismissed. In 
five cases, the doctors involved were 
cautioned, and charges of professional 
misconduct against four doctors were 
sent to the college's discipline commit- 
tee. 

Dr Dawson said the appointment of 
Mrs. Kennedy was one of several steps 
the college is taking to "restore public 
confidence in the ability and intention 
of the college to deal equitably with 
complaints against doctors." 

In addition to being a regular panelist 
on the long-running TV show, Mrs. 
Kennedy is public affairs editor for a 
Toronto radio station. ^ 

APRIL 1971 




IF YOU'RE HAVING 
PROBLEMS WITH I.V.s 
TRY THE I V OMETER 

Varying flow rates, bottles emptying too fast or too slow, 
infiltrations and stopped needles are common I.V. prob- 
lems. 

The IVOmeter, a disposable metered I.V. set has been 
shown to reduce the severity and frequency of these prob- 
lems. The nurse can now observe an indicator which 
shows, at a glance, the current flow rate compared to the 
desired flow rate. Because of the Stay-Set clamp the nurse 
can be assured that any change in flow is patient oriented. 

To find how IVOmeter's patented meter and clamping 
technique can eliminate drop recounting and assist in 
improving patient care, just complete and mail the coupon 
shown below to: 

I 'V- OMETER, INC. P.O. B0XI219 Santa Ouz, Callf. 95O6O 




.Zip. 



Hospital 

Title/Position 



I V- OMETER, INC. p o box 1219 

A subsidiary ol Intermed Corporation 



SantaCruz, Calif. 95060 



THE C/^ADIAN NURSE 23 



names 



B Betty Sellers (R.N., 
Regina General 
Hospital School of 
Nursing, B.Sc.N., 
U. of Saskatoon; 
M.N., U. of Wash- 
ington, Seattle) has 
been appointed to 
the newly created 
position of nursing 
service consultant with the Alberta 
Association of Registered Nurses. She 
is responsible for developing and con- 
ducting a nursing service consultation 
program aimed at assisting health agen- 
cies to provide and maintain a high 
quality of nursing. 

Miss Sellers has been a staff nurse 
at the Regina General Hospital. Start- 
ing as supervisor, she became assistant 
director, and then director of nursing 
at the University Hospital in Saskatoon. 
Later, she was director of nursing at the 
Queen Elizabeth Hospital in Toronto. 
More recently Miss Sellers has been 
an assistant professor and associate 
director of a research unit at the Univer- 
sity of Toronto School of Nursing. 

Grace Carter (R.N., 
Wellesley Hospital 
School of Nursing, 
Toronto) became 
the first National 
Education officer 
of the Canadian 
Cancer Society on 
February 1, 1971. 
To quote Miss 
Carter, "I share the belief of many 
dedicated volunteers that cancer can 
be prevented and many more cures 
would be possible if people would 
seek early treatment. My job will 
be to sell this message to the Cana- 
dian public and to induce them to act 
on it." 

During her early nursing career, 
Miss Carter worked in Michigan and 
California, taking time to study jour- 
nalism at the University of California 
in Berkeley. On her return to Toronto, 
she worked as neurosurgical nurse for 
a private practitioner. 

In 1953, Miss Carter joined the 
Canadian Pacific Railway Company, 
where her most recent assignment has 
been convention sales manager of the 
Royal York Hotel in Toronto. 

Miss Carter has many extra-profes- 

24 THE CANADIAN NURSE 





sional interests. She is a charter member 
of the board of governors of Seneca 
College of Applied Arts and Technolo- 
gy, a member of Executives' Secretaries 
Inc., the Ontario Hotel Sales Manage- 
ment Association, and is on the advisory 
council of the Arts of Management 
Conferences sponsored by the Toronto 
Business and Professional Women's 
Club. 



Sharon B. Tiffin 

(R.N.,U. of Alberta 
Hospital School of 
Nursing, Edmonton) 
is serving a two- 
year tour of duty 
with MEDICO, as 
one of a team of 
Canadians working 
in Surakarta (Solo) 
in the province of Central Java. She is 
involved in training student nurses and 
upgrading nursing services at local 
hospitals. 

Miss Tiffin has worked at St. Paul's 
Hospital, Vancouver, and with the 
Canadian Red Cross Blood Trans- 
fusion Service. She has also been em- 
ployed at Lions Gate Hospital in North 
Vancouver. Later, she studied midwifery 
at the University of Alberta and then 
worked at Providence Hospital, Fort 
St. John, B.C. 



J. A. McNab, executive director of 
Toronto General Hospital, has an- 
nounced the appointment of Eileen D. 
Strike as director of nursing service for 
the hospital, effective June 1, 1971. 
Miss Strike will join the staff on May 
10 to begin orientation. 

Miss Strike (R.N., 
The Montreal Gen- 
eral Hospital School 
of Nursing; B.Nurs., 
McGill U., Mont- 
real; M.Sc, Boston 
U.) worked at the 
Royal Edward Chest 
Hospital in Mont- 
real as associate 
director of nursing from 1961 to 1963. 
She was special assistant to the director 
of nursing of The Montreal General 
Hospital from 1963 to 1965, when 
she was named associate director of 
nursing service at that hospital, a posi- 
tion she has filled to the present except 




/ 



for a period of leave to attend Boston 
University as a Canadian Nurses' Foun- 
dation Scholar. 

Miss Strike has been active as an 
execiftive member of The Montreal 
General Hospital school of nursing 
alumnae association and was chairman 
of the associate membership of the 
United Nurses of Montreal in 1967-68. 
She has held executive positions on 
both district and provincial committees 
of the Association of Nurses of the 
Province of Quebec, including among 
others, the committee on labor rela- 
tions (1967-69) and the committee on 
nursing service (1969-70). She was a 
member of the legislation committee 
( 1 966) and the resource committee — 
Study of the Nursing Profession in 
Quebec (1970). 

Miss Strike is currently a member 
of the CNA standing committee on 
nursing service. 



Ruth K. Schinbein (R.N., Saskatoon 
City H.), obstetrical supervisor at West 
Lincoln Memorial Hospital, Grims- 
by, Ontario, has been elected chairman 
of the Ontario section of the nurses' 
association of The American College 
of Obstetricians and Gynecologists. 

The purpose of the nurses' associa- 
tion of ACOG, which has grown to 
3,600 members in the U.S. and Canada, 
is to promote, in conjunction with the 
College, the highest standards of obstet- 
ric, gynecologic, and neonatal nursing 
practice and education; to cooperate at 
all levels with qualified physicians 
and nurses; and to stimulate interest 
in obstetric, gynecologic, and neonatal 
nursing. 



Margaret Cammaert (B.Sc.N., U. of 
Alberta; M.P.H., Johns Hopkins U., 
Baltimore), chief nurse with the Pan 
American Health Organization in 
Washington, D.C., paid an official visit 
to the department of national health 
and welfare in February. 

She met with the principal nursing 
officer, Verna Huffman, and other 
nursing consultants to discuss the role 
of the nurse in the delivery of health 
care. Miss Cammaert visited CNA 
House on February 1 1 , and at the 
opening of the three-day Nursing Con- 

(Conliniied on page 26) 
APRIL 1971 



LA CROSS HAS 
BEAUTIFUL IDEAS 



There's more to La Cross than pro- 
fessional good looks. Count on La 
Cross for comfort, long wear and 
easy care fabrics. La Cross . . . the 
name to trust for value in quality 
nursing fashions. 



^ 



Action sleeve gussets, self belt and front zipper on 
the jacket. Pants are sold separately. 

80% DACRON — 20% COTTON 

Style 5046 (Jacket) Retails about $13.98 

Style 5034 (Pants) Retails about $10.98 

SIZES 6-18 



This and other styles available at uniform shops and 
department stores across Canada. 



« 



PROFESSIONAL UNIFORMS 

For a copy of our latest catalogue and 
for the store nearest you, write : 

La Cross Uniform Corp. 

4530 Clark St., 

Montreal, Quebec 

Tel : 845-5273 







•. •.•■••.•.4 



LUCY 
0-1788 



THE SECRET 
IS IN THE 

Buoh 

it moulds itself to the shape of your 
foot curve for curve, giving evenly 
distributed buoyant support where it 
is needed. 




Conventional Insoles 




Cradle Arch Insole 




But that's not all: 

• Until now, shoes were made to fit 
only the length and width of the 
foot. Now White Cross scientific 
3-WAY FIT ensures perfect 
fit around the girth too. 

GIRTH 





• All White Cross Shoes are 
HY-GE-NIC for added comfort 
and protection. 

• Up to 6 FITTINGS are avail- 
able on most styles. 




A BEAUTIFUL WAY TO BE COMFORTABLE. 




JUDITH 
0-2431 



BRIGITTE 

0-1861 





At better shoe stores across Canada. 



names 



26 THE CANADIAN NURSE 



(Conliniiedfri)iii pajjc 24) 

ference on Research in Nursing Prac- 
tice on February 1 6. extended greetings 
on behalf of her organization to those 
present. She came to Canada direct 
from Venezuela where she participated, 
in a seminar on nursing systems. 

Miss Cammaert, a Canadian, has 
had extensive experience in Canada 
and a number of Latin American coun- 
tries. She was appointed to her present 
position in 1968 and is responsible for 
all program planning for nurses 
throughout the region of the .Americas. 



Betty Mclnnes (Reg.N., St. Joseph's 
School of Nursing, Hamilton; B.Sc.N., 
U. of Toronto; M.Sc.Ed., U. of Niag- 
ara, N.Y.) has written a 95-page 
volume, The Vital Signs, and is the 
first Canadian to have a book on nurs- 
ing published by the C.V. Mosby 
Company of the United States. 

Her book is set out in the program- 
med manner and will be incorporated 
into the curriculum next year at St. 
Joseph's school of nursing where Miss 
Mclnnes has been on the teaching staff. 

For the current year, Miss Mclnnes 
has been relieved of teaching duties 
in order to be the school's audiovisual 
coordinator. 

Maurice Dignard (R.N., Laval U., Que- 
bec), formerly of Montreal, has been 
decorated by the Government of 
Jordan for his work with an emergency 
team sent to Amman by MEDICO, a 
service of CARE, to assist in treating 
casualties of the recent war. 

Mr. Dignard and his teammates 
were awarded gold medals inscribed 
in gratitude for their "round the clock" 
aid to victims of the street fighting. 

For the past year, Mr. Dignard has 
been operating room nurse with a 
MEDICO team stationed in Tunis, Tu- 
nisia. During the emergency in nearby 
Jordan, he and his teammates were 
temporarily transferred to the Jordan- 
ian capital of Amman. 

Mr. Dignard specialized for a year 
in operating room nursing at Hotel 
Dieu of Quebec. He then organized 
and supervised the emergency room at 
Hotel Dieu, Levis, and later headed 
the emergency clinic at the Hydro- 
Quebec Dam Project. He has also been 
operating room supervisor at Charles 
LeMoyne Hospital, and officer in 
charge of purchasing material and sup- 
plies for the operating room at Hotel 
Dieu, Montreal. ^ 

APRIL 1971 




^ 



>^« 




kj 




Vr. 




t: 



"^ 



^ 




'^6 



"*i ifi 



1^ 



^^'TH.Q. 






i 



A Superb Text ,, , 
Now Better 

I rfa/f even Extensively revised to include new 
nursing and medical entities, this edition offers a realistic, 
clinical presentation of individualized nursing care, firmly 
grounded in the biologic, social and behavioral sciences. 

Dorothy W. Smith, R.N.. Ed.D.; Carol P. Hanley Germain, 
R.N., B.S.N. , M.S.; and Claudia D. Gips, R.N., Ed.D. 



About 11 60 Pages 

410 Illustrations 

Spring, 1971 

About $13.95 



Philadelphia • Toronto 



new products { 



Descriptions are based on information 
supplied by the manufacturer. No 
endorsement is intended. 




Day-Timer's Myfar 

Myfar (my financial affairs record) is 
an aid to iceeping financial affairs in 
order. Adapted to Canadian tax and 
estate laws, it combines in one book all 
information connected with one's fi- 
nancial affairs, investments, purchase 
and sale of securities, real estate and 
other property, and applicable income 
and expenses. 

This book has many uses. For ex- 
ample, in the event of loss through 
fire, theft, or other casualty, the prep- 
aration of a proof of claim can be sim- 
plified by reason of the inventory and 
insurance records provided in Myfar's 
personal property inventory and insur- 
ance section. 

Further information may be obtained 
from Day Timers of Canada Limited, 
109 Vanderhoof Avenue, Toronto, 
Ontario. 

Kynol Flame Resistant Fiber 

Kynol flame resistant fiber, manufac- 
tured by The Carborundum Company, 
is now available in 13 different fabric 
weaves and weights, including twill, 
herringbone, and basket weaves. 

Kynol phenolic fiber, orange-gold 
in color, is an organic whole fiber that 
retains its identity when exposed to fire 
as it does not melt. 

28 THE CANADIAN NURSE 



Present applications of Kynol fiber 
include protective clothing, gloves, 
face masks, and helmet liners. Other 
uses for Kynol fabric now under consid- 
eration include upholstery fabrics for 
hospitals, hotels, and offices where fire 
may be a grave threat. 

For further information, write to 
the Carborundum Company, Niagara 
Falls, New York 14302, U.S.A. 

Crown Industrial Aerosols Catalog 

This illustrated catalog gives a complete 
listing of Crown aerosol products — 
lubricants, paints, cleaners, adhesives, 
to name a few. It is available from 
Crown Industrial Products (Canada) 
Limited, 1616 Charles Street, Whitby, 
Ontario. 



Disposable Face Mask 

Hal-Genie, a new disposable face mask 
for hospital and clinical use, has been 
developed by Halbrand, Inc. 

"Hal-Genie," with a filtration pad of 
non-woven rayon fiber in the breathing 
area, slips over the ears easily and fits 
securely over the mouth and nose area. 
It has a contouring clip to secure it over 
the nose. "Hal-Genie" is lightweight, 
non irritating, can be washed for reuse, 
and can be autoclaved. 

The product comes packaged in in- 
dividual protective poly bags and the 
face masks are packaged in dispensing 
boxes. 

Information on Halbrand's full line 
of disposable products is available by 
writing to Halbrand, Inc., 4413 In- 
dustrial Parkway, Willoughby, Ohio, 
44094, U.S.A. 



Flotation Pad Brochure 

A new brochure. The Extra Margin of 
Safety, shows how the Stryker Floatation 
Pad adds a new dimension to the pre- 
vention and treatment of decubitus 
ulcers. The cushion contains a chemi- 
cally inert silicone gel, making it an 
effective measure against superficial 
tissue breakdown. 

In the brochure, an anatomical chart 
clearly illustrates the usual locations of 
pressure sores, and photos of sacral, 
throchantric, and ischial sores are re- 
minders of the pain and discomfort 
accompanying decubitus ulcers. 

A thin latex cover over the gel makes 



the Stryker Floatation Pad a medium of 
unrestricted pressure equalization to 
absorb critical and shearing force pres- 
sure. The Pad may be used in any bed 
or wheelchair to protect pressure points. 
Stryker heel and knee cushions are also 
available for patients confined to bed. 

For free copies of the brochure, 
write to the Stryker Corporation, 420 
Alcott Street, Kalamazoo, Michigan 
49001, U.S.A. 

Computer Analyzed ECGs 

Telemed Corporation offers around- 
the-clock computer analysis of electro- 
cardiograms through a dual configura- 
tion of Xerox Data Systems Sigma 5 
computers. Multiple telephone lines 
connect the central computer facility to 
remote coupled ECG units located in 
hospitals, diagnostic and industrial 
clinics, medical centers, nursing and 
convalescent homes, and physicians" 
offices. 

The computer analyzes pertinent 
ECG amplitudes and durations, wave 
forms from each of the 1 2 leads of the 
scalar electrocardiogram, rate, and 
electrical axis, producing an interpreta- 
tion of the status of the electrical func- 
tion of the heart based upon these para- 
meters. The analysis is then transmitted 
by telephone to a teletype unit on the 
subscriber's premises, ready for assess- 
ment by the physician. The analysis is 
returned within 10 minutes after taking 
the ECG. 

A 12-page brochure, describing this 
service, is available by writing the Tel- 
emed Corporation, 9950 West Law- 
rence Ave., Schiller Park, 111. 60176. 

B.M.D. — A Real "Un-Plugger" 

G.H. Wood make a new product, B.M. 
D., which seems to be the answer to 
plugging problems in wash basins, 
sinks, toilets, bathtubs, drains, and 
any other water runways. 

B.M.D. does not contain caustic and 
is generally safe to use. Drain odors 
and poor drainage caused by accumu- 
lation of grease, organic soil, etc., can 
usually be eliminated overnight. The 
bacterial action of B.M.D. works 
fast to dissolve grease and other wastes. 

Full details are obtainable from 
G.H. Wood, the "Sanitation for the 
Nation" Company, Queen Elizabeth 
Way, Box 34, Toronto, or from any 
of its 50 sales branches in Canada. 

APRIL 1971 



Synthetic Absorbable Surgical Suture 

The first synthetic absorbable suture, 
Dexon, has been introduced in Canada 
by Davis & Geek, Cyanamid of Canada 
Limited. 

Approved by the Food and Drug 
Directorate in June 1970, the Dexon 
polyglycolic acid suture combines the 
flexibility of silk with superior tensile 
strength, fray resistance, and consistent 
knot security, and causes little or no 
tissue reaction. It is the first absorbable 
suture ever made from a laboratory- 
engineered polymer especially designed 
to meet the specific requirements of 
surgeons. 

A special sterile package for Dexon 
to save time in preparing sutures in the 
surgery suite, was developed to aid 
operating room nurses. Dexon, ready 
to use as it emerges from an easily- 
opened, vacuum-sealed envelope, is 
available in a full range of suture sizes 
needle combinations to fit most surgical 
needs. 

Preclinical investigations are present- 
ly being conducted to extend the use of 
Dexon to the specialized fields of car- 
diovascular, neural and ophthalmologi- 
cal surgery. 

Further information may be obtained 
from Davis & Geek Products Depart- 
ment, Cyanamid of Canada Limited, 
P.O. Box 1039, Montreal 101, Quebec. 

Drum-Cartridge Catheter 

Abbott Laboratories, Limited, has 
announced the availability of the Drum- 
Cartridge Catheter, a catheter-through- 
needle unit. This new catheter has been 
designed especially for monitoring 
central venous pressure and may be 
used as a companion to Abbott's CVP 





Single Check Value 



Manometer. A preassembled cartridge 
contains 28 inches of catheter tubing 
coiled inside a drum. 

Aseptic extension of the radio-paque 
catheter is controlled by rotating the 
drum — one revolution introduces 
approximately five inches of tubing 
into the patient's vein. The Drum- 
Cartridge Catheter can be held in one 
hand without touching the sterile cath- 
eter tubing and, after catheter place- 
ment, the drum cover pops off with 
finger pressure. The remaining compo- 
nents disassemble quickly and are 
ready for connection to an intravenous 
administration set. 

A short-bevel, 14-gauge thinwall 
needle provides ease of administra- 
tion and reduces tissue and vein trauma. 
A full length folding needle guard pro- 
tects the operator and patient from 
possible injury by folding open for 
venipuncture, and by locking in place 
along the full length of the needle after 
venipuncture. 

Further information may be obtained 
from Abbott Laboratories Limited, 
P.O. Box 6150, Montreal, P.Q. 

Pall Single Check Valve 

The Biomedical Division of Pall Cor- 
poration has developed a disposable 
single check valve, a companion to the 
popular disposable Pall dual check 
valve. 

This new check valve, a plastic dis- 
posable device with no moving parts, 
insures unidirectional flow of liquids 
and gases. Available with tubing or luer 
connections, and able to withstand 80 



APRIL 1971 



psi pressure, the new Pall Valve can be 
readily attached to plastic tubing or any 
apparatus with standard luer fittings. 
When installed in each of several branch 
lines feeding a common trunk, back- 
flow of the mixture into the branch line 
is prevented, and cross or reverse con- 
tamination of products is avoided. It 
may be used as a vacuum breaker in 
closed vessels and as a low cost diode 
in fluidic circuits. 

For information on the Pall Single 
Check Valve and the complete bio- 
medical line, write to Biomedical Pro- 
ducts Division, Pall Corporation, 30 
Sea Cliff Avenue, Glen Cove, N.Y. 
11542, U.S.A. 

Dual Temp Refrigerators 

Foster Refrigerator of Canada Ltd. 
recently released two bulletins illustrat- 
ing "Today" line dual temp refrigera- 
tors. 

All these dual temps have two separ- 
ate refrigeration systems, both balanced 
Fostermatic. The Today line, includes 
four self-contained and five top-mount 
dual temp models ranging from 18 to 
92 cubic foot capacity. 

Of welded aluminum, stainless steel, 
or a combination aluminum/stainless 
steel, they have either plate coil or 
electric automatic defrost freezer sec- 
tions. Accessories include five types of 
tray slides, insulated glass doors, dial 
thermometers, and high-low tempera- 
ture alarm systems. 

Write Foster Refrigerator of Canada 
Ltd., Janelle Street, Drummondville, 
Quebec, for information. ■§■ 

THE CANADIAN NURSE 29 



in a capsule 



Hold that smile 

In the House of Commons recently, 
MP Heath Macquarrie asked some 
interesting questions about the effect 
of certain brands of toothpaste on 
tooth enamel. 

"Mr. Speaker," he said, "whether 
we all have clean hands and a pure 
heart or not, Canadians do try to clean 
their teeth quite often, and when I 
asked a question the other day about 
abrasive qualities in toothpaste used 
by Canadians, I was not being facetious 
or loose-lipped. It is very important, 
considering the dangers inherent in 
toothpaste as discovered in areas of the 
United States, that we in Canada know 
exactly what is the potential for injury 



in the toothpaste which is used by mil- 
lions of Canadians." 

Mr. Macquarrie said the findings 
of three organizations in the US — the 
National Academy of Sciences, the 
US food and drug administration, and 
the American Dental Association — 
were quite disturbing, as they showed 
that many well-known toothpastes on 
the market have qualities that are in- 
jurious to the dental health of their 
users. 

"One news item indicates there is 
an abundance of abrasive material in 
one brand which is injurious to tooth 
enamel and, therefore, contributes 
to early decay," Mr. Macquarrie said. 
"Another points out that of 1 1 brands 




30 THE CANADIAN NURSE 



which claim to prevent or retard tooth 
decay, only two have any right to that 
claim whatsoever, and one is doubt- 
ful .. . " 

The Honorable Member then pleaded 
■ with the minister of national health 
to give the Canadian people reassur- 
ance, guidance, and suggestion. "... 
the mouths of Canadians are important, 
too," Mr. Macquarrie said. 

Do nurses see MDs as a good "catch"? 

To find out what nurses really think 
of doctors in terms of possible mates, 
the monthly magazine Canadian Doctor 
sent a reporter to interview several 
nurses. The results, published in the 
January issue of that magazine, may 
surprise many MDs. 

Most nurses interviewed do not be- 
lieve a physician is a good catch. "Marry 
a doctor? Good God, no!" said one. 

Various reasons were given by the 
nurses as to why they have a different 
idea of the MD than popular doctor- 
nurse paperbacks would indicate. "The 
doctor isn't God to us any more," said 
one nurse. "We're better trained than 
ever before and I think this is attracting 
a more intelligent and independent- 
thinking type of girl. We're more co- 
workers than subordinates now, and 
the idea of the nurse kneeling meekly 
in obeisance before the doctor has 
become ridiculous ..." 

Most nurses interviewed said the 
time a physician spends away from 
home would be one of the biggest disad- 
vantages to marrying him. 

One nurse interviewed said: "It's 
more to the doctor's advantage to marry 
a nurse than to her advantage. He gets 
a woman who is well educated, effi- 
cient, who can usually talk about a wide 
variety of subjects, and who under- 
stands the problems of being a doctor." 

The article reveals that there are still 
some nurses who would marry a doc- 
tor. One said: "I'd marry a doctor 
because I think it's a worthwhile profes- 
sion, but I'd give the problem serious 
thought before I rushed into it. As for 
more nurses being starstruck by the 
doctor, I think it's more likely to be 
the girl who is not a nurse who is eager 
to rush to the altar with the intern she 
met last Saturday night." 

The article concludes: "It is encour- 
aging to remember that only a small 
fraction of womankind is drawn to 
nursing." § 

APRIL 1971 



for use 
-on the ward 
-in the OR 



-in training 



NEOSPORir 

IRRIGATING 

SOLUTION 

Available: Sterile Ice. Ampoules, 
Boxes of 10 and 100. 

INSTRUCTIONS FOR USE 

This preparation is specitically designed foi use with S cc. 
"thiee-way caiheteis or with other catheter systems p«fmit- 
ling continuous irrigation of the uimary tiitddet. 

1 PREPARE SOLUTION 

Using sterile precautions, one (1 ) cc. of Noosponn trtiga- 
ting Solution should be added to S 1,000 cc. bORIe of 

sterile isotonic saline solution 

2 INSERT INOWELUNG CATHETER 

Catheleiiie the palieni using full sterile ptecaulions. The 
use of an antibacterial lubricant such as Lubaspofin* Urethral 
Antibacterial Lubricant is recornmended during Insertion of 
the catheter 

INFLATE RETENTION BALLOON 

Fill a Luei type syringe with 1 cc. of sleiile watei or saline 
(S cc. for balloon, the remamcler to compensate lor the 
volume required by the inllalion channel) Insert syringe 
o valve of balloon lumen, inject solution and remove 
^ syringe 

IPONNECT COLLECTION CONTAINER 

e outflow (drainage) lumen should be asepticatly con- 
[Cled, via a sienle disposable plastic tube, to a sterile 
jposable plastic collection bag (bottle). 

\tACH rinse SOLUTION 

) inflow lumen of the 5 cc "three-way" catheter should 
n be connected to the bottle of diluted Neosporin 
jalion Solution using sterile technique. 

f ADJUST FLOW-RATE 

It patients inflow rate of the diluted Neosporin 
Irrigating Solution should be adjusted to a slow drip to 
deliver about 1,000 cc every twenty-lour hours (about 
40 cc. per hour) II the patient's urine output exceeds 2 
liters per day >i is recommended that the inflow 'ale be 
adjusted to deliver 2,000 cc. of the solution in a Iweniy- 
louf hour period This requires the addition of an ampoule 
ol Neosporin IrriQatpng Solution to each of two 1.000 cc 
bodies of sterile saline solution. 

• KEEP IRRIGATION CONTINUOUS 

It IS important thai irrigation olthe bladder be continuous 
The rinse bottle should never be allowed to tun dry. or the 
inflow dfip interrupted for more than a few minutes The 
outflow tube should always be inserted into a sterile 



# Convenient product idenlilying labels lor use on bottles 

of diluted Neosporin Irrigating Solution are available in each 
ampoule packing or from your 'B. W & Co.' Hepresonlalive. 



1 




1 
1 


f= 







fe 



Burroughs Wellcome & Co. (Canada) Ltd. 






Neosporin' Irrigating Solution 



INSTRUCTIONS FOR USE 



Designed especially for the nursing pro- 
fession, this Instruction Sheet shows 
clearly and precisely, step by step, the 
proper preparation of a catheter system 
for continuous irrigation of the urinary 
bladder. The Sheet Is punched 3 holes to 
fit any standard binder or can be affixed 
on notice boards, or in stations. 

For your copy (copies) just fill in the cou- 
pon (please print) noting your function or 
department within the hospital. 



Dept. S.P.E. 

Burroughs Wellcome & Co. (Canada) Ltd. 

P.O. Box 500, Lachine, P.O. 

Gentlemen : 

Please send me 1 1 copy (copies) of the N.I.S. Instructions for Use. My department or function 



within the hospital is_ 



NAME. 



ADDRESS. 



CITY OR TOWN. 



.PROV. 



I""""! 

"Trade Maik 

APRIL 1971 




Burroughs Wellcome & Co. (Canada) Ltd. 

THE CANADIAN NURSE 



31 












comfortable/economicai/tiinesaving/retelast 



® 



^■f Available in 9 

^9f different sizes. 

jf^S The original tubular 

^^'f elastic mesh bandage 

*^'^ § allergy free, indispen 

* for hospital care. 

New stretch weave a 

^ maximum ventilatioi 

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/ i I ^ \ X comfort and speedy h 

/ / \ »k ' ^ ^' Demonstration upon r 



OPINION 



Research^ apple juice^ 

and daffodils — 

a good combination . 



The editors asked the author to give 
her reactions to the conference on 
research in nursing, held in Ottawa 
February 16 to 18,1971. 



The first national conference on re- 
search in nursing practice should be 
heralded as a historical event in Cana- 
dian nursing, whether or not it lived 
up to the promise of its title. That 
judgment is the prerogative of the 
individual registrant. 

The conference brought together, 
with British Columbia apple juice 
and daffodils, nurses from a variety 
of practice settings, nurses with many 
affiliations, including health care agen- 
cies and institutions, government, and 
universities. The program focused 
on the exploration of problems — prob- 
lems centered around research in pro- 
fessional practice and problems of 
carrying out research in nursing. 

On the final afternoon, precious 
time was spent on the problem of ap- 
proving resolutions that attempted 
to represent the consensus of a diverse 
group that had had little time to explore 
the basic issues underlying the resolu- 
tions. 

In his speech that initiated the con- 
ference. Dr. Norman Grace suggested 
that the primary objective of research 
is to add to our store of knowledge. 
He continued by distinguishing bet- 
ween "s e a r c h" and "research." 
"Search" is concerned with looking up 
existing information. At the confer- 
ence the resources were people rather 
than books, and the three days were 
well used to search for and share exist- 
ing information on how to proceed if 
one wanted to "do" research in nurs- 
ing and to know what or who facilitated ■ 
it. 

As one experienced in working with 
nurse researchers. Dr. Robert Leonard 
pointed out that most nursing research 
in the past has not included the patient, 
confirming that the basic unit of clini- 

APRIL 1971 



Dorothy J. Kergin, R.N., Ph.D. 

cal nursing research is the nurse and 
patient. In retrospect, one wonders 
whether this basic unit could have 
received more serious consideration 
during the conference. For instance, 
what are our ethical obligations to the 
patient and his family concerning such 
matters as informed consent? 

Dr. Faye Abdellah provided the 
conference with a concise view of the 
development of research in nursing in 
the United States. She pointed to the 
changing health care systems of the 
'70s and the implications of these 
changes for nursing research. It is 
unfortunate that her expertise was not 
utilized to discuss criterion measures 
in nursing. 

One wonders, too, if a Canadian 
expert on methodology in nursing re- 
search could have presented a scholarly 
paper on the research process that 
would have equalled Dr. Loretta Heid- 
gerken's presentation and perhaps been 
practically related to the "how" of 
research. Was the planning committee 
too modest to look for someone among 
its members? Perhaps in the future we 
can identify such an expert within our 
own boundaries. 

The program participants were all 
gentle, supportive, and encouraging. 
Some delegates would like to have 
heard a speaker who was provocative 
and challenging. 

Aside from Dr. John F. McCreary's 
remarks about research needed in the 
delivery of health services, the impor- 
tance of interdisciplinary and collabo- 
rative research in health care received 
little attention. Is research in nursing 
generally too fragile for us to face the 
fact that no health profession, includ- 
ing nursing, can solve its problems in 
isolation? What is the nature of profes- 
sional interdependence now and in the 
future? How can nursing capitalize on 



Dr. Kergin is Director. School of Nurs- 
ing, McMaster University, Hamilton 



the interest of colleagues, particularly 
physicians, in collaborative studies? 

What innovative practices have been 
tried successfully by nurses in educa- 
tional or practice settings? It would 
have been helpful to know the out- 
comes of "search" or "research" pro- 
jects, rather than just project titles and 
objectives, as listed in three papers 
presented at the conference. Is nursing 
research so new that we must wait for 
another conference to find out? 

Would "brain-storming" in small 
groups to identify problems of nurs- 
ing practice have resulted in proposed 
methodologies or application of the 
findings from other studies to achieve 
solutions? Could innovative practices 
have been discussed that might have 
been tested in small trials not requiring 
the financial and other resources that 
characterize major, funded research? 
Will a major outcome of the conference 
be a fiood of research grant applications 
from nurses to federal and provincial 
departments of health? If so, a number 
of nurses must anticipate rejection. 
There is a limit to public funds, and 
we are all taxpayers. 

Better still, can we look for reports 
in professional journals of the creative 
application in new settings of research 
findings from studies that were listed 
for the conference participants? 

Hindsight is a temperamental critic. 
The Canadian nursing profession owes 
its thanks to the University of British 
Columbia, the members of the planning 
committee, and the department of 
national health and welfare for focus- 
ing attention on the needs and problems 
of research in nursing and nursing 
practice, and for providing a forum to 
explore these areas. 

As Verna Huffman, principal nurs- 
ing officer, office of the deputy minist- 
er, DNHW, stated in her opening re- 
marks, the conference represented the 
attainment of a degree of maturity for 
the nursing profession. It remams for 
the profession to provide evidence as to 
the extent of this maturity. § 

THE CANADIAN NURSE 33 



National conference 
on research in nursing practice 



A capsule account of Canada's first national conference on research 
in nursing practice, held in Ottawa February 16 to 18. 




"Our emphasis at this conference has 
been on nursing practice — and this is 
where the emphasis should remain," 
said project director Dr. Floris E. King, 
associate professor and coordinator of 
the graduate program at the university 
of British Columbia's school of nursing. 
34 THE CANADIAN NURSE 



"The conference was a terrific first 
step . . . ■" 

This comment, made by one of the 
340 nurses who attended Canada's 
first national conference on research 
in nursing practice, describes accurately 
the general reaction to the conference. 
It was, indeed, a terrific first step; in 
fact, it could even be described as a 
giant leap that may well get nursing 
research off the ground and over some 
of the hurdles that have stood in its 
way in the past. 

Not that all the problems were solved 
at this conference — far from it. But 
there was a sense of enthusiasm, an 
eagerness to become involved in re- 
search or at least to learn more about 
it. And there was agreement that this 
was only the beginning, that many 
other conferences on research will be 
held in future. 

Further evidence of nurses' keen 
interest in research to improve patient 
care was found in the large number 
of registrants (early press releases 
stated registration was limited to 200), 
and the diversity of the registrants' 
occupation and educational back- 
ground — staff nurses, nurse educators, 
supervisors, directors of nursing, public 
health and visiting nurses, head nurses, 
graduate students — all were represent- 
ed. 

The conference, sponsored by the 
University of British Columbia school 
of nursing with the support of the 
department of national health and wel- 
fare, was designed to stimulate research 
in nursing practice. Its specific objec- 
tives, as outlined by the project director 
Dr. Floris E. King, associate professor 



and coordinator of the graduate program 
at UBC's school of nursing, were to 
identify needs for research, explore 
methodology, and improve the coordi- 
nation and the communication of re- 
search nationally. 

Problems in research 

Problems inherent in research were 
presented by several speakers at the 
opening session. Dr. Norman S. Grace, 
president of the Association of Sci- 
entific Engineering and Technological 
Community of Canada and general 
manager of the Dunlop Research Cen- 
tre, spoke about research problems in 
professional practice. He began by 
defining his basic philosophy on re- 
search. 

"I suggest that the primary objec- 
tive of research is to add to our store 
of knowledge," he said. "Increasingly, 
people are misusing the word 'research' 
when they really mean 'search.' ... If 
you go to look up existing information 
in the library, you are searching, not 
researching." 

Dr. Grace said the good researcher 
not only questions the unknown, but 
also questions what appears to be 
known. This takes courage, he added, 
because most people do not like to 
question established concepts. Crea- 
tive persons are needed for research, 
he added, and it is not always easy 
to recognize them. One recently pub- 
lished study concluded that creativity, 
based on various arbitrary standards, 
did not correlate with intelligence or 
class standing. "By hiring from the top 
of the class, you are not ensuring that 
you are getting the most creative grad- 
uates," he warned the audience. 

APRIL 1971 




Keynote speakers — Dr. Faye Abdellah, left, who presented a paper on the devel- 
opment of nursing research, and Dr. Loretta E. Heidgerken, who discussed the 
research process. Their papers will be published in a future issue of The Canadian 
Nurse. 




Creative people are needed for research, said Dr. N. Grace, center, and it is diffi- 
cult to indentify these persons. Dr. W. Brehaut, left, and Dr. B. Quarrington, 
right, spoke about research in other disciplines. 
APRIL 1971 



Dr. Grace spoke of the difficulties 
involved in selecting a problem on 
which to do research. 

"While superficially there never 
appears to be a shortage of problems 
on which to do research, in actual 
practice this area is often the most 
difficult: difficult to decide on what is 
really important, difficult to clarify 
the heart of the problem, and difficult 
to develop a meaningful attack. With 
the best planning and care, there are 
strong elements of timing and luck. 
If you are too early, some of the mate- 
rials, facilities, methods, and the like, 
may not be available. If you are too 
late, then someone else has preempted 
the field. Luck comes in many ways, 
including timing and importance," he 
said. 

"One has to be lucky, too, in the 
way in which one develops research 
personnel, research facilities, and 
problems or research projects. If too 
much emphasis is placed on acquiring 
new and very expensive facilities at 
too early a stage, there is a temptation 
to take on projects without regard to 
their importance, just to keep the new 
facilities busy. The same situation can 
arise if you develop too big a research 
team too early. There is a tendency to 
feel you must keep them busy, even on 
trivia, while you are hopefully search- 
ing for the right problem to work on. 
In these and many other ways, it is 
easy to become a data gatherer rather 
than a problem solver." 

Dr. Grace's advice to those inter- 
ested in research was to concentrate 
on important ideas, reduce problems 
to fundamentals, get the best advice, 

(ConliniucI on pane 3S) 



THE CANADIAN NURSE 

% 



35 




A. 

... All those In favor? Hands up, please! 

B. 

. . . almost everyone had a tape recorder! 

C. 

Dr. John F. McCreary, dean of the fac- 
ulty of medicine at the University of 
British Columbia, spoke about research in 
the delivery of health services. He is seen 
with M. Thibaudeau, left, chairman of 
one of the sessions, and Joyce Nevitt, 
director of the school of nursing at 
Memorial University, St. John's, New- 
foundland. 

D. 

Money is available from the National 
Health Grant for well-designed projects, 
and nurses should apply for these grants, 
said panelist Pamela E. Poole, right. 
Other panelists are, from left. Dr. Amy 
Griffin and Rose Imai. 

E. 

Anna Gupta, left, acting director of the 
University of Windsor school of nursing, 
chats with Dr. Faye Abdellah and Dr. 
Beverly Du Gas, nursing consultant, 
health manpower resources, department 
of national health and welfare. 
F. 

Sister Mary Stella, director ot nursing 
education at St. Joseph's Hospital, Ham- 
ilton, and Dr. Helen K. Mussallem, 
executive director of the Canadian 
Nurses' Association. Dr. Mussallem sum- 
marized the proceedings on the final day. 

G. 

. . . some even worked during the coffee 

break. 




and look ahead. "Remember," he said, 
"research is carried out to influence 
the future." 

Speakers from other disciplines told 
of the problems their professions had 
encountered in conducting research. 
Dr. Bruce Quarrington, professor of 
psychology at York University, Toron- 
to, said: "If you, as nurses, feel you 
have lagged behind other disciplines 
in the development of your own re- 
search resources, then I would say 
to you, as a researcher in applied psy- 
chology, that you haven't missed much 
— until recently." However, Dr. Quar- 
rington was optimistic about the future, 
and indicated that nursing research 
could benefit from past mistakes of 
the other health disciplines. 

Dr. Willard Brehaut of the Ontario 
Institute for Studies in Education spoke 
harshly about past research in educa- 
tion. "... much of the educational re- 
search that has been conducted has 
been so inadequate as to be little more 
than a research exercise," he said. "It 
is no wonder, then, that it has been 
disregarded; indeed, it is probably 
fortunate for all of us that it was dis- 
regarded." 

Dr. Brehaut said that despite the 
large amount of research that has been 
done on the teaching-learning process, 
little is known about what goes on 
between teacher and child in the class- 
room. "Because man is a poor subject 
for science, do not be surprised or 
discouraged if, after much research 
in nursing, you find that the nurse- 
patient relationship is among the last 
aspects of nursing to yield its secrets," 
he said. 

38 THE CANADIAN NURSE 



Basing his comments on the failures 
and successes in educational research. 
Dr. Brehaut gave this advice to nurses: 

• Research sould be seen as an en- 
terprise in which the practitioner — 
in this instance, the staff nurse — has 
an important part to play from begin- 
ning to end, from the initiation of the 
research to the implementation of the 
results. 

• If research is to be done, both time 
and money must be made available — 
and the prime requisite is time, time 
away from other duties. 

• Nurses must focus on the patient 
as the chief beneficiary of their labors, 
lest they lose sight of the primary objec- 
tives of their research. 

• Research is a service to the nurse, 
an important service, but no substitute 
for the basic activity of nursing. 

• There is a need to provide a sound 
theoretical base for the research con- 
ducted. If this base is lacking, the 
studies undertaken will tend to be 
fragmented bits and pieces of research 
that add little or nothing to the sum 
total of professional knowledge. Even- 
tually this will lead to the rejection by 
practitioners of the important contribu- 
tion that research can make to the nurs- 
ing profession. 

Dr. Robert Leonard, a well-known 
American sociologist and presently 
visiting professor, faculty of nursing, 
the University of Western Ontario, 
gave his views on clinical research. 
Pointing out that most nursing research 
has not included patients, he said there 
seems to be more concern about the 
practitioner than about the patient. 
As examples of this non-clinical re- 



search, he listed. studies that involved 
staffing, manpower, nursing activities, 
and nursing attitudes. "In all these non- 
clinical kinds of research, the con- 
nection to patient care remains hypo- 
thetical," he said, "because the patient 
is not included." 

How does one go about doing clin- 
ical research? "First, by clinical ex- 
perience, by nursing patients," Dr. 
Leonard said. "Through clinical ex- 
perience the nurse identifies prob- 
lems of patient care. She records this 
experience to document the existence 
of the problem. Then she compares 
notes with other clinicians. She tries 
out different possible solutions to the 
problem. When a solution has been 
developed, then a principle of practice 
has emerged or a familiar principle has 
found a new application .... This is 
the point where systematic, objectified 
research methods are applied," he 
said. 

After citing several clinical studies 
that have been carried out. Dr. Leonard 
concluded by saying that studies do not 
get repeated as much as they should, 
that they tend to remain isolated ex- 
amples of what can be done. "Con- 
sequently," he said, "we do not yet 
see examples of clinical nursing re- 
search that have compelled some widely 
adopted improvement in patient care." 

Research activities in Canada 

On the second day of the confer- 
ence, delegates were given a bird's- 
eye view of research activities in nurs- 
ing in Canada. Pamela E. Poole, nurs- 
ing consultant, hospital services study 
unit, department of national health 

APRIL 1971 



Panelists on the, final day of the confer- 
ence discussed the climate needed for 
research, communication, the project 
design, and other topics. Photo at far 
left sliows Dr. Moyra Allen, associate 
professor. School For Graduate Nurses, 
McGill University; Jean-Yves Rivard, 
professor of the department of health 
administration. University of Montreal; 
and Dr. Josephine Flaherty, assistant 
professor, department of adult edu- 
cation, Ontario Institute for Studies 
in Education. Photo at left shows 
M. Geneva Purcell, director of nursing. 
University of Alberta Hospital; Kay G. 
DeMarsh, assistant executive director 
of the Winnipeg General Hospital and 
first vice-president of CNA; and Dr. 
Margaret Cahoon, professor and chair- 
man of research. University of Toronto 
School of Nursing. 



and welfare, gave an overview of re- 
search that has been sponsored or 
conducted by governments and service 
agencies; Rose Imai, research officer, 
Canadian Nurses' Association, spoke 
about the role of professional associa- 
tions in nursing research in Canada; 
and Dr. Amy Griffin, assistant dean 
(academic) and coordinator of graduate 
programs at the University of Western 
Ontario, reported on research com- 
pleted at Canadian university schools 
of nursing within the past 10 years, and 
projects currently being conducted. 

Dr. Griffin based her paper on the 
results of a questionnaire she sent in 
December 1970 to the 22 university 
schools of nursing. Twenty of the 
schools responded. The bulk of the 
research reported came from those 
schools having graduate programs, she 
said. Research completed by faculty 
totalled 20 projects, as contrasted with 
a total of 1 12 completed by graduate 
students; on the other hand, faculty 
research in progress totals 36, as con- 
trasted with 25 in progress by graduate 
students. Most of the projects have 
been confined to nursing research 
alone. Dr. Griffin said, with fewer 
projects being of an interdisciplinary 
nature. However, there has been a surge 
of interdisciplinary projects recently, 
she added, particularly in the area of 
delivery of health service. 

The response to Dr. Griffin's ques- 
tionnaire revealed a dearth of publica- 
tion of nursing research. Only one 
graduate student's thesis had been 
published, and faculty have done "a 
little better." The picture is not as 
gloomy as might first appear. Dr. Grif- 
APRIL 1971 



Resolutions Approved 

The following resolutions were approved by the delegates on the final day of 
the conference on research in nursing practice. 

D Resolved that this conference support the establishment of a National Coun- 
cil of Health and that this Council include representation from the nursing 
profession. 

D Resolved that research conferences and forums both at national and regional 
levels be held on a regular basis in order that continued ettort be made to 
encourage research in nursing practice, to aid in the stimulation of ideas 
and dissemination of information pertaining to research in nursing practice, 
and to avoid duplication. 

n Resolved that presentations on research developments be included in pro- 
grams of national and provincial nursing association meetings. 

D Resolved that this conference suDOort the establishment of a national in- 
formation retrieval centre for the overall development of the health sciences. 

D Resolved that guidelines be developed for nursing research ethics. 

D Resolved that research courses be available as part of continuing education 
programs for nurses. 

D Resolved that employers of nurses be encouraged to establish sabbatical 
leave pwlicies to facilitate advanced study and research projects. 

D Resolved that university schools of nursing engage in systematic programs 
to develop research skills of faculty. 

D Whereas funds for research training grants and fellowships and nursing 
studies are available through the National Health Grants, and 
Whereas these funds to date have not been fully utilized by nurses. 
Be it resolved that health care agencies, educational institutions, individual 
nurses, and nursing associations increase efforts to submit applications. 

n Resolved that the planning committee of this conference meet in order to 
summarize and evaluate the Conference. 

D Resolved that multidisciplinary research in the provision and evaluation of 
health care be increased. 

D Resolved that the Canadian Nurses' Association begin publication of mono- 
graphs of research studies and documents, similar to those published by the 
National League for Nursing as League Exchanges. 



fin said, as copies of theses are usually 
placed in the libraries of universities, 
and are available on inter-library loan 
and from the Canadian Nurses' Associa- 
tion. 

Concluding her paper, Dr. Griffin 
said a small beginning has been made 
and that there is a serious intent to push 
forward. " Whether it is pxissible to do 
so is contingent on two major factors: 
provision of better initial and ongoing 
preparation in research for faculty, 
and sufficient release of faculty time 
to engage in research." 

General discussion 

Many relevant issues and questions 
were raised throughout the conference 
by both the panelists and the audience. 
Here are a few questions and answers, 
followed by several interesting com- 
ments: 

Q. Can we get help to design a research 
project? 

A. Consultation services are available 
from the department of national health 
and welfare to assist in the design 



of a research project, to assist on a 
continuing basis if desired, and to 
help analyze the data. Also, some 
university faculties provide help. 

Q. How can we get information about 
research studies being carried out 
in various institutions? 

/I. The health grants directorate of the 
department of national health and 
welfare publishes annually a list of 
projects funded by the federal govern- 
ment. Also, at least one provincial 
nursing association (RNAO) plans 
to make a survey of research being 
conducted in the province. 

Q. What is the first step in setting up a 
research project? 

A. Identify and define your objectives. 
All too often a researcher gathers 
statistics and data first, without defin- 
ing his objectives. There is no logic 
to this. 

Comment: Only a small percentage of 

those in any discipline will go into 

research, and we should try to identify 

THE CAi^DIAN NURSE 39 



those who can learn research meth- 
ods. However, every nurse has a role 
that has research implications. 

Comment: We have to create a climate 
in which research can be done. In 
a profession where there are so many 
sacred cows, you have to know which 
cow you're upsetting so as not to cut 
off the supply of milk. 

Comment: A dichotomy exists between 
those in universities and those in 
service agencies. As long as this 
dichotomy exists, we can in no way 
do good research. 

Comment: Researchers must involve 
practitioners of nursing, otherwise 
the research will be scuttled. 

Comment: We need a nursing research 
journal in Canada. 

Comment: The profession is ready for 
the full-time nurse researcher who 
could work with a research team of 
nurses. 

Emphasis should remain on practice 

The success of this first national 
conference on research in nursing 
practice was obviously gratifying to 
those on the planning committee and 
especially to project director Dr. Floris 
E. King. We asked Dr. King to give us 
her reaction. 

"There have been feelings of extreme 
optimism expressed throughout the 
conference," she said, "and a feeling 
that this is a new era, that it is the start 
of something big. There's a sense of new 
freedom as well, freedom to grow, to 
demonstrate things, to try things. And 
this is the crucial factor that we really 
need in the nursing profession today 

— this spirit of development. 
"Many things can happen as a re- 
sult of this conference — what they 
will be, I really don't know. But I can 
see that more research conferences will 
be held .... Our emphasis at this con- 
ference has been on nursing practice 

— and this is where the emphasis should 
remain . . . . " ^ 



U 



WHAT DID NURSES 
THINK OF THE CONFERENCE? 

— here are a few comments 



33 



It's about time we had a conference on the subject 

Nurse Educator. 



"A fantastic conference! 
of nursing research . . . ." 

"An excellent, well-organized conference. It has been part of my professional 
enrichment. A follow-up conference should be held in a year or two." 

Consultant. 

"\ really enjoyed this conference, and hope there will be future ones on 
research held on a regional as well as national basis. At the next conference 
I'd like to see someone take a piece of research and dissect it, showing how it 
can be applied in the nursing service areas 'back home.' " Director of Nursing. 

"For me, the highlight of this conference was the chance to see and hear 
many of the well-known leaders in nursing. I found the conference very 
helpful, as we are presently involved in a project to establish quality patient 
care in our hospital. A pre-conference session would have been of value, as 
persons of various levels of educational preparation were represented here." 

Assistant Coordinator of /[Medical Nursing. 

"Although I am not practicing my profession at present, I could not pass up 
the opportunity to attend this great event. I really feel stimulated by this 
conference, and it has made me think I should return to university and 
learn more about research and methodology." 

Homemal<er and Former Nurse Educator. 

"An excellent conference. It has given me a chance to meet other nurses in 
Canada who are interested in research, find out what they are doing, and 
share ideas with them. Also, several of the studies mentioned by the panelists 
were of great interest to me as I had not heard of them before. I plan to 
read these studies and fxjssibly make use of their findings." 

Director of Nursing. 

"I was very disappointed. There was too much presentation of information 
that could have been obtained in other ways. Everyone got the same 'pack- 
age.'whether they needed it or not. There should have been two groups set 
up for the discussion period — one group composed of those engaged in 
research, the other composed of those interested in research, but who have 
had no preparation in this area. Personally, I felt uninvolved for three 
days." Nurse Educator. 

"A very stimulating conference. I had a minimal amount of training in 
research in my university program and realize now that I have much to 
learn. I liked the emphasis put on clinical practice. We need to get back to the 
clinical setting, look at some of the problems there, and then think of what 
research needs to be done. At the next workshop or conference on research, 
I'd like to have more time for group discussion." Nurse Educator. 

"A very informative conference, but I don't see where I fit in to research. 
One thing I got from it is that I need to return to university and learn more 
about research methodology. In a way I feel rather frustrated because I 
realize there is so much to know and do. We need future conferences to 
show us how we can participate." Director of Nursing. 

'This conference has' opened many doors to me. The most exciting thing has 
been to talk to others and find out what they are doing in the area of 
research." Nursing Supervisor. 

"I felt that the conference was primarily geared to the faculty of universities, 
rather than to hospital staff. Little was said about studying problems on a 
nursing unit and how staff nurses, head nurses, and clinical instructors could 
do research. I found parts of the conference stimulating, but did not under- 
stand all that panelists and speakers were saying." i-lead Nurse. 

"This conference is a terrific first step, and I'd like to see it followed up 
with another that goes a step beyond this. We should share the research we're 
doing with others. I'm taking part in a workshop in my community next 
month, and plan to use some of the information I've obtained here." 

Director of Nursing Education. 



Management of Parkinson's 
disease with L-dopa therapy 



The effectiveness of L-dopa against the symptoms of Parkinson's 
disease has been confirmed by numerous clinical trials involving 
several hundred patients. 



Eunice Tyler 

James Parkinson (1755-1824), a gen- 
eral practitioner in London, was a man 
of many talents. He not only made 
major scientific contributions to geol- 
ogy and paleontology, but was a prom- 
inent political reformer as well. Par- 
kinson wrote on a variety of medical 
subjects, the best known being the syn- 
drome that now bears his name. His 
graphic description established paral- 
ysis agitans as a recognizable entity 
in 1817. ] 

Additional clinical features have 
since been described, including a dis- 
tinction between the rigidity and the 
akinesia that occur in the syndrome. 
As Parkinson had no autopsy material 
to study, he erroneously predicted 
that the lesions of paralysis agitans 
would be found in the cervical spinal 
cord. Later, pathological studies of 
idiopathic parkinsonism showed char- 
acteristic abnormalities in the brain. 
In some cases there is an initiating 
cause, such as encephalitis lethargica, 
but for most, the etiology remains 
unknown. 

Mrs. Tyler, a graduate of Bristol Ho- 
meopathic Hospital, Bristol, England, is 
presently Head Nurse of Neurology, 
Toronto General Hospital. Toronto, On- 
tario. She gave this speech in Toronto at 
the June 1970 meeting of the Canadian 
Association of Neurological and Neuro- 
surgical Nurses. 



APRIL 1971 



Parkinson's disease is a chronic 
brain condition characterized by ri- 
gidity, slowness of movement, tremor, 
a mask-like face, shuffling gait, and 
emotional depression. Patients com- 
plain of weakness of their muscles. We 
have seen the distressing sight of the 
patient who cannot turn in bed, get 
out of a chair, walk without shuffling, 
tie his own shoes, eat without spilling, 
and who becomes resigned to a life of 
invalidism. 

The disease is more prevalent than 
most people realize. In Ontario, for 
example, there are an estimated 40,000 
victims, including 10,000 in Metro 
Toronto. 

Medical management 

James Parkinson's skeptical attitude 
toward the medicinal treatment of the 
disease could also apply to the anti- 
cholinergic compounds — of limited 
value — which became the mainstay 
of medical management. Current re- 
search, however, gives hope of pro- 
viding more effective drug therapy. 

One successful approach has been 
the treatment of parkinsonism by 
stereotaxic surgery. In many cases, 
stereoencephalotomy has resulted in 
stricking amelioration of tremor and 
rigidity. 2 This technique has prompted 
an interest in the pathophysiology of 
the basal ganglia, and, with more 
knowledge of the biochemistry of the 
THE CA^NADIAN NURSE 41 



basal ganglia, is bringing a better under- 
standing of the disorder. 

Doctor Oleh Hornykiewicz, formerly 
of Vienna and now at the Clarke Insti- 
tute of Psychiatry in Toronto, discov- 
ered that the brain of the parkinsonian 
patient was deficient in a chemical 
called dopamine. 3| A similar observa- 
tion was made at the same time by a 
group of McGill University scientists, 
headed by biochemist T. L. Sourkes. * 

Unfortunately, the deficiency could 
not be made up by the direct use of 
dopamine, because the chemical would 
not pass directly from the blood to the 
brain. This problem was partially 
overcome with the discovery of L-dopa 
by Dr. George Cotzias of the Brook- 
haven National Laboratory in Long 
Island, New York. ^ The solution was 
only partial, because the blood-brain 
barrier was still largely impenetrable 
and large quantities of L-dopa had to 
be used. This was expensive and pro- 
duced intense side effects. 

The discovery of a new drug, known 
as RO4-4602, by Dr. Hornykiewicz, 
is a significant advance in L-dopa ther- 
apy. 6 If taken with L-dopa, it allows 
more of the L-dopa to get through to 
the brain, and therefore the patient can 
get by on smaller quantities of L-dopa. 
Dr. Andre Barbeau, a pioneer in the 
drug treatment of Parkinson's disease, 
has been carrying on clinical tests for 
some years at Montreal's Clinical 
Research Institute, and he is opti- 
mistic about developments in the treat- 
ment of Parkinson's disease. ^ 

Advantages and disadvantages. 

The effectiveness of L-dopa against 
the symptoms of Parkinson's disease 
has now been confirmed by numerous 
clinical trials involving several hundred 
patients. All investigators have reported 
favorable results in most patients. ^ 
Some patients have been on the drug 
for 18 months or more with continuing 
relief of bradykinesia, rigidity, and the 
rnental depression associated with the 
disease. Many patients have reported 
an increase in sexual desire and potency, 
and enhancement of smell and taste. 

The most serious of the reported 
adverse effects are orthostatic hypo- 
tension and cardiac arrhythmias. Treat- 
ment is started with small doses (100 
to 250 mg.), which are then gradually 
increased over a period of many weeks. 
Careful supervision of the patient with 
cutbacks in dosage as indicated usually 
prevent serious hypotensive episodes. 
Orthostatic hypotension tends to di- 
minish with continued treatment. 
42 THE CANADIAN NURSE 



Cerebrovascular insufficiency and 
stroke have also been reported, but 
evaluation of the significance of adverse 
cardiovascular and cerebrovascular 
disorders occurring in patients on L- 
dopa is difficult, as the drug is usu- 
ally given to patients in the age groups 
in which such disorders are relatively 
common. 

Other adverse effects of L-dopa 
include anorexia, nausea, vomiting, 
and dyskinesia. None of these side 
effects is serious, and can be quickly 
reversed or controlled by reduction 
of the dose. Nausea and vomiting can 
often be prevented if the patient takes 
the medication with food and in more 
frequent, but smaller, doses. In fact, 
the most common adverse effects of 
L-dopa can be minimized by slow and 
gradual increase of daily dosage over 
a period of weeks of months. 

Dyskinesia is observed only in pa- 
tients who receive large doses close to 
the maximum therapeutic dose. This 
adverse effect consists mainly of chorei- 
form movements of the face, tongue, 
neck, and extremities. Slight increase 
in blood urea and uric acid has been 
observed in some patients, and delirium 
and hallucinations occur occasionally. 
These effects are reversed by reducing 
the dose or withdrawing the drug. No 
persistent hematological disorders 
have been encountered. Positive 
Coombs' tests in some patients have 
been noted. 

One of the physicians who pioneered 
the successful use of L-dopa, Dr. Cot- 
zias, states, "The optimal daily dose . . . 
has averaged 5 .8 Gm. per day (maximum 
8 Gm. per day) and maximal improve- 
ment has rarely been achieved in less 
than six weeks. In some cases we and 
others have noted further improvement 
several weeks after a steady dose was 
established .... It is likely that the 
vomiting, anorexia, and orthostatic 
hypotension encountered by others 
starting the regimen was due to a rapid 
rate of increasing the drug .... Dis- 
tribution of the daily dose among at 
least six or seven portions appeared es- 
sential." 9 



Summary 

L-dopa has been studied experi- 
mentally in several hundred patients for 
about two years and has proved to be 
an effective remedy for symptoms of 
Parkinson's disease. With proper cau- 
tion in dosage, serious or irreversible 
adverse effects have been observed in 
relatively few patients. 



As with all new drugs, it is probable 
that longer use will disclose new ad- 
verse effects. But most patients with 
disabling or advancing parkinsonism 
would be willing to take that risk as 
an alternative to hopeless invalidism 
and despair. 

References. 

l.Wilkins. R. H. and Brody. 1. Parkin- 
son's syndrome. Arch. Neurol. (Chi- 
cago) 20: 440-1, Apr. 1969. 

2. Cooper, I.S. Parkinsonism: Its Medi- 
cal and Surgical Therapy. Springfield, 
III., Charles C.Thomas, 1961. 

3. Ehringer, H. and Hornykiewicz. O. 
[Distribution of noradrealine and 
dopamine (3-Hydroxytyramine in the 
human brain and their behaviour in 
diseases of the extrapyramidal system ] 
Klin. W.uhr. 38:1236-1239. Dec. 15, 
1960. 

4. Sourkes, T.L. and Poirier, L.J. Neuro- 
chemical bases of tremor and other 
disorders of movement. Canad. Med. 
Ass. J. 94:53-60, Jan.8. 1966. 

'5. Cotzias, G.C. et al. Aromatic amino 
acids and modifications of parkinsonism 
New Eng. J. of Med. 276:374-9, Feb. 
16, 1967. 

6. Hornykiewicz, O. Dopamine (3-hy- 
droxytyramine) and brain function. 
Pharmacol. Rev. 18:925-64, June 1966. 

7. Barbeau, A. L-Dopa therapy on Par- 
kinson's disease: a critical review of 
nine years' experience. Canad. Med. 
Ass. J. 101:791-800, Dec. 27. 1969. 

8. A second report on levodopa. Medical 
Letter on Drugs and Therapeutics, vol. 
1 1, no. 18, issue 278. Sep.5, 1969. 

9. Cotzias, G.C. et al. L-Dopa in parkin- 
son's syndrome. New Eng. J. Med. 28 1 : 
272,July31, 1969. ■§■ 



APRIL 1971 



By Wendy Stockdale 



The Cancer Patient 



As you . . . 

My fellow being lie before me. 

Weak and tired 

And grasp my hand in pain 

With eyes that plead - 

"Don't let me die," 

I think in sadness - 

Ah, my brother 

Tis a plea beyond my realm 

or power to grant. 

But from within me 

comes a voice 

Too clear to doubt ^^ 

Too real to shun 

That says - my friend, 

I cannot grant you life . . . 

I am but your servant here; 

But I can gaze 

With steadfast faith 

Into your eyes 

and silently - 

Or with words you choose 

Can help you find that strength within 

To fight your battle. 

I cannot fight it for you. 

Nor can I cause its end; 

But I can try to ease some of the pain 

along the way. 

This only can I promise - 

if, though in pain. 

You heed your soul. 

If you build courage, strength, 

endurance - 

To fight that mystic foe 

Then, if you win your life 

You've won its essence, too 

And if you die - 

You die in well-earned honor 

and in peace. 



Miss Stockdale is a 

third-year nursing student at the 

University of Alberta Hospital. 




Myo-electric control 
— one more aid 
for the amputee 

Recently, myo-electric control has been applied to an increasing number of 
amputees In Canada, and is being encountered by clinical as well as research 
staff. This article explains the principles of myo-electric control and describes the 
operation of various control systems that are of clinical significance. 



44 THE CANADIAN NURSE 



R.N. Scott, P.Eng. 

In the past several years the press has 
carried frequent reports of myo-elec- 
tric control systems, often with a head- 
line such as "artificial arm controlled 
by nerves." What is a myo-electric 
control system? Let us start with a 
definition: A myo-electric control sys- 
tem uses the electric signal from a 
muscle to control the flow of energy 
from a source (battery) to an actuator 
(motor). Although such a system can be 
used for many purposes, its chief use 
is to control the, artificial limbs of per- 
sons with upper-extremity amputa- 
tions. It is this application that is de- 
scribed in this article. 

Historical perspective 

Myo-electric control is not new. The 
first practical myo-electrically control- 
led prosthesis was demonstrated at th'" 
Exportmesse in Hanover in 1948.^ 
This excellent work by Reinhold Reiter, 
of Munich, was not followed up, per- 
haps due to the unfavorable postwar 
industrial situation in Germany. It was 
not until 1960 that another clinical- 
ly useful, myo-electrically controlled 
prosthesis appeared, this time in Mos- 
cow. Unlike Reiter's earlier system, 
this development by Kobrinski^ at- 

Professor Scott is Executive Director 
of the Bio-Engineering Institute and 
Professor of Electrical Engineering, 
University of New Brunswick. 



tracted great attention. Indeed, it is 
widely cited as the first practical myo- 
electric control system. 

Although considerable research ef- 
fort has been devoted to myo-electric 
control in the U.S.A.,^''^^ England,' 
Denmark and Sweden,^ Japan,^ and 
Canada, '° the only commercially- 
available myo-electrically controlled 
prostheses (outside the U.S.S.R.) are 
made in Duderstadt, West Germany 
(the Myo-Bock system) and Vienna, 
Austria, (the Myomot system). Both 
resemble Kobrinski's system in func- 
tion, with significant refinements in 
design. 

The myo-electric signal 

The origin of a myo-electric signal 
is the depolarization of the cell mem- 
brane of individual muscle fibers during 
contraction. The electric currents 
associated with this depolarization and 
the subsequent repolarization produce 
measurable potential differences in 
tissues some distance away. It is these 
potentials, rather than the transcellular 
potentials, which are used in myo- 
electric control. 

The smallest number of muscle fi- 
bers that can contract, under normal 
circumstances, is the group that has 
its innervation from a single nerve 
axon. This functional unit (fibers, 
axon, and cell body of neuron in the 
spinal cord) is called a motor unit. 
Conscious voluntary control of the 

APRIL 1971 



contraction of single motor units in 
skeletal muscle is possible,'^ but re- 
quires a high degree of concentration. 
Consequently, the electric potentials 
from single motor units have not been 
used widely for myo-electric control. 

When a large number of motor units 
are active, the resulting "gross myo- 
electric potential" has a waveform 
similar to that shown in Figure 1. If 
this waveform is analyzed, it is found 
that most of the energy lies in the fre- 
quency range of 30 to 300 cycles per 
second, and that the peak-to-peak 
amplitude during voluntary contrac- 
tion may range from a few microvolts 
to several millivolts. (These figures 
assume measurement with electrodes 
on the skin surface.) 

Certain characteristics of the gross 
myo-electric potential — for insta.ice 
the "area under the curve" — are 
roughly proportional to the force ex- 
erted by the muscle for small to mod- 
erate isometric contraction. However, 
the important point for control use is 
that the "amount" of myo-electric sig- 
nal is subject to conscious voluntary 
control. This is true of muscles atrophi- 
ed from disuse, of partially innervated 
muscles, of normally-inner\ated muscle 
remnants resulting from amputation. 

The electrode problem 

One of the most difficult problems 
in achieving a practical myo-electric 
control system is to establish good 
electrical contact between the signal 
source (the muscle) and the electronic 



control equipment. The skin is an elec- 
trical insulator. Also, the underlying 
tissues are conductive and permit sig- 
nals from many muscles to be measured 
at any one location. 

Surgically-implanted telemetry sys- 
tems may eventually overcome some 
of these problems, and there is a possi- 
bility that a reliable percutaneous con- 
ductor may be developed. At present, 
however, all systems in clinical use 
employ surface electrodes. 

The resistance between the surface 
electrode and the highly conductive 
tissues under the skin is "in series with" 
the signal source. If the input resistance 
of the electronic system is low compar- 
ed to this electrode-to-tissue resistance, 
serious reduction of signal occurs. If 
the input resistance of the electronic 
system is raised to avoid this problem, 
the whole system becomes more sen- 
sitive to electrical interference from 
the environment. 

The high resistance of the skin is a 
property of the epidermis. Although 
removal of this outer layer of skin — 
for example, by rubbing it with an abra- 
sive paste — will solve the problem for 
a single measurement, it cannot be pro- 
posed for a chronic application. A 
conductive cream or paste, or even 
perspiration, will lower the skin resis- 
tance greatly, without abrasion, merely 
by partially penetrating the epidermis. 

Intermittent contact or even slight 
relative movement between a rigid 
electrode and the skin will produce 
electrical "noise" that may be greater 



Myo-electric 
Potential 




I: Typical Gross Myo-electric Signal 



APRIL 1971 



than the myo-electric signal. The best 
electrodes in this resjject provide some 
means of holding the metallic part of 
the electrode at a fixed distance from 
the skin (typically 2 to 3 mm.). The 
space between is filled with a conduc- 
tive electrode paste that provides elec- 
trical contact and reduces skin resis- 
tance. 

At any contact between dissimilar 
materials, including an electrode-to- 
tissue contact, a "contact potential" 
exists. For metallic electrodes in con- 
tact with biological tissues, this poten- 
tial is typically several hundred milli- 
volts. Fluctuations in this contact px)- 
tential constitute electrical "noise" 
that may exceed the myo-electric sig- 
nal level. To achieve a stable contact 
potential, a sintered silver-silver chlor- 
ide pellet is often used in preference 
to a pure metal in electrodes for bio- 
electric measurement. 

The problem of measuring potentials 
from a number of muscles simulta- 
neously, when the signal from only 
one muscle is desired, is not solved 
easily. The potential from a muscle 
fiber decreases very rapidly with 
distance from the fiber. Thus it is im- 
portant that the electrode be placed 
close to the muscle whose activity is 
to be measured. 

If other active muscles are relatively 
far away, the interference signal from 
them, referred to as "crosstalk," will 
be small. Small electrodes permit im- 
proved spatial selectivity, but have the 
disadvantage of increased electrode- 
to-tissue resistance. As long as surface 
electrodes are used, this selectivity 
problem will continue to place serious 
limitations on the selection of myo- 
electric control sites. 

The control system 

A myo-electric control system, in 
its simplest form, controls the flow of 
current to an electric motor in accor- 
dance with the "amount" of myo-elec- 
tric signal. In practice, at least three 
distinct elements exist in the system: 
an amplifier, a signal processor, and a 
controller. 

The amplifier increases the ampli- 
tude of the myo-electric signal to a 
convenient level. Amplifier gain, the 
ratio of output to input signal, may be 
in the order of 10,000, and is usually 
adjustable so that the sensitivity of the 
system can be matched to the require- 
ments of the individual patient. 

Differential amplifiers are employed 

in most myo-electric control systems 

because of their ability to discriminate 

THE CANADIAN NURSE 45 



I btate I 
-State I (off) — J II [• — State III (Openingl- 

(Closing) 



6 I 

Max. 
Noise 



J L 



Max. Vol. 
Contraction 



Myoelectric 
Signal 



2: "Three-State" Control 



Motor 
Current 




Myoelectric 
Signal 



Opening 



3: "Three-State Variable" Control 



against external electrical interference 
and to permit the use of a common 
power supply in multichannel systems. 
With a differential amplifier, a "refe- 
rence" or "common" electrode (some- 
times referred to incorrectly as a 
"ground" electrode), is used, together 
with two "active" electrodes for each 
channel. The electric potential differ- 
ence between the two active electrodes 
is amplified, while any signal (such as 
external interference) that exists "in 
common" between the active electrodes 
and the reference electrode is not am- 
plified. 

The instantaneous value of the myo- 
electric signal is not useful for control 
purposes. Rather, some characteristic 
that represents the "average activity" 
over a time interval must be used. The 
selection of the characteristic that is 
most useful has been the object of much 
research, thus far inconclusive. In the 
absence of any clear preference, the 
choice has been made on the basis of 
circuit simplicity, and most control 
systems use a processor that approxi- 
mates, crudely, the "average area under 
the curve." 

The design of the processor involves 
a difficult compromise. An accurate 
determination of the "amount of sig- 
nal," the average value of the charac- 
teristic discussed above, requires a 
certain time, with the accuracy increas- 
ing as the sampling time is increased. 
However, rapid response to voluntary 
changes in the myo-electric signal re 
quires that the processor recognize 
46 THE CANADIAN NURSE 



these changes without significant time 
delay. 

It is customary to design for time 
delays of about 0.2 seconds, which 
seem to be reasonably satisfactory in 
terms of system response, and to accept 
the resulting degree of smoothing as the 
best that can be obtained. One signifi- 
cant technique for obtaining a smooth- 
er, though not more accurate output, 
is described by Bottomley. '•' 

Having obtained, at the output of 
the processor, an electric signal that 
represents the "amount" of the myo- 
electric signal, it remains to use this 
signal to control an actuator, such as 
the motor in an electric hand. The 
simplest control scheme, used in what 
we call a "two-state on-off system," 
requires a level sensor and a switch. 
When the processor output reaches a 
preset level, the switch operates to 
turn on the motor. Two such systems 
are used in the U.S.S.R., Otto Bock, 
and Viennatone equipment, one to 
control closing and one to control 
opening of an electric hand. 

As long as the myo-electric signals 
:o both systems are less than the 
switching level, the hand remains in 
a fixed position (motor off)- Some form 
of protective circuitry is used to prevent 
activating both the closing and open- 
ing systems simultaneously. A major 
disadvantage of this scheme, and one 
that becomes particularly critical with 
high-level amputees, is that two con- 
trol muscles are required to operate a 
single function. For some patients 



this scheme permits selection of control 
muscles on the basis of their original 
function. 

Another application of the two- 
state on-off system has been useful 
with young patients. Only one muscle 
is used. The terminal device is con- 
nected so that it closes unless the myo- 
electric signal exceeds a certain level, 
in which case the terminal device 
opens. This results in a normally- 
closed, voluntarily-opened mode of 
operation and requires only a single 
control muscle. A limit switch is re- 
quired to disconnect the motor when 
the terminal device is fully closed to 
prevent wasting electrical energy. As 
it does not permit less than full closing 
force, this scheme is not recommended 
for terminal devices having high pinch 
force. 

A better control scheme, used in 
what we call a "three -state on-off sys- 
tem,"i3 uses only one control muscle 
and involves a controller that monitors 
the processor output with respect to 
two preset levels. If the output is less 
than the lowest level, the hand remains 
in a fixed position (motor ofO- If the 
processor output exceeds the lower 
level but is less than the upper level, 
the hand closes. If the output is greater 
than the upper level, the hand opens. 
A slight time delay incorporated into 
the closing circuit permits the patient 
to make the transition from "off" to 
"opening" without any closing action. 

Operation of a three-state control 
system and the designer's problem in 

APRIL 1971 



selecting optimum switching levels 
are illustrated in Figure 2. In this 
diagram, "A" represents the maximum 
expected inadvertent myo-electric sig- 
nal, crosstalk, and other "noise." Clear- 
ly, the first switching level, "B", must 
lie well above "A" to avoid accidental 
operation of the prosthesis. "D" rep- 
resents the maximum voluntary myo- 
electric signal that the patient can a- 
chieve. 

Clearly, the second switching level, 
"C", must be well below "'D" to avoid 
fatigue. (At the University of New 
Brunswick we prefer not to have "C" 
higher than roughly 1/3 of "D".) But 
"C" must be well above '"B" to make it 
easy for the patient to hold the system 
in State II. Any selection is a compro- 
mise, as these are conflicting require- 
ments. It should be noted that training 
of the patient will usually increase "D" 
and lower "A". Also, it will reduce the 
fluctuations in voluntary myo-electric 
signal, making a narrower second 
state ("B" to "C") acceptable. Thus 
all aspects of the compromise are re- 
lieved by training. 

Some designers have experimented 
with a "four-state on-off control sys- 
tem." This differs from the three -state 
in providing a second "off state be- 
tween the two active states. This has 
not generally proven to be a signifi- 
cant improvement, the greater tlexi- 
bility being obtained at the cost of 
increased crowding of the region "A" 
to "C". 

Some powered prosthetic compo- 
nents move so slowly (most electric 
elbows) or have so little pinch force 
(the Ontario Crippled Children's Centre 
child's size electric hook) that on-off 
control is adequate. Others, such as 
the Otto Bock Z-6 electric hand, devel- 
op their high pinch force very slowly, 
so that good control of force is easily 
achieved with on-off control. How- 
ever, this is not true of all devices. 
Where it is necessary to control motor 
torque (and hence speed or force), the 
motor current is made to vary as a 
continuous function of the "amount" 
of myo-electric signal. 

Such a system gives "proportional 
control" if the motor current is a linear 
function of myo-electric signal. Often 
a non-linear function is better. The 
U.N.B. "Three-State Variable" con- 
trol system provides continuous con- 
trol of closing force (or speed) and on- 
off control of opening, as shown in 
Figure 3. 

The major limitations of myo-elec- 
tric cofitrol (indeed of all powered 
APRIL 1971 




Self-contained, self-suspended prosthesis with myo-electric 
control of an electric hand. Patient has congenital absence of left 
forearm. (Cosmetic "glove" has been removed to show removable 
battery pack.) Hand is made by Otto Bock, Duderstadt, West 
Germany. 




Prosthesis partly disassembled to show electronic control unit. 

THE CANADIAN NURSE 47 




Illustrative bimanual activities for which a functional prosthesis is essential. 



prosthetics) at present become evident 
when simultaneous control of two or 
more functions is required. An ade- 
quate number of good control sites is 
rarely available, and the patient, de- 
pending almost entirely on visual 
feedback for information as to the 
action of his prosthesis, is forced to 
attend to one function at a time rather 
than attempt smoothly coordinated 
movements. 

We hope that current research on 
telemetry of myo-electric signals from 
deep muscles, utilization of small seg- 
ments of muscles as control sites, re- 
cognition of subtle patterns of activity 
in a number of muscles, and particu- 
larly on providing supplementary 
feedback from the prosthesis to the 
patient, will contribute to the solution 
of these problems. 

References 

1 . Reiter, R. Eine neue Eiektrokunsthand. 
Grenzgehiete cler Medizin, 1:4:133-5, 
Sept. 1948. 

2. Kobrinski, A.E., et al. Problems of 
bioelectric control: in automatic and 
remote control. (Proc. 1st. IFAC Int'l. 
Congress, Moscow, 1960.) Butter- 
worths, London, vol.2, pp 619-23 
1961. 

48 THE CANADIAN NURSE 



4. 



Reswick, J.B. Final report, biomedi- 
cal research program on cybernetic 
systems for the disabled. Cleveland, 
Ohio, Case Western Reserve Univer- 
sity, Engineering Design Center, 
EDC Report 4-70-29, 1970. 
Long, Chas. II. Normal and abnormal 
motor control in the upper extremi- 
ties. Cleveland. Ohio, Case Western 
Reserve University, Ampersind 
Group, Final Report on SRS RD- 
2377-M, 1970. 

Childress, D.S. Design of a myo- 
electric signal conditioner. J. Audio 
Eng. Soc. 17:3:286-91, June 1969. 
Antonelli, D.J. and Waring, W. Myo- 
electric control of powered devices. 
Archives Phys. Med. Rehuh. 48 345- 
9, July 1967. 

Bottomley, A.H. Myo-electric control 
of powered prosthesis. J. Bone Ji. 
Surg. 47B:3:4\\-]5 Aug. 1965. 
Herberts, P. Myo-electric signals in 
control of prostheses. Acta Ortho- 
paedica Scandinavica, Suppl. no 124 
1969. 

Kato, I., Okazaki, E., and Nakamura, 
H. The electrically controlled hand 
prothesis using command disc and/or 
EMG. J. Society Imtrumeni and 
Control Engineers, 6:4:236-41, Anril 
1967. 



10. Scott. R.N. Myo-electric control sys- 
tems, in Advances in Biomedical 
Engineering and Medical Physics. 
S.N. Levine, Ed. New York, Wiley- 
Interscience Publishers, 2:45-72 
1968. 

1 1. Basmajian, J.V., and Simard T.G. 
Methods in training the conscious 
control of motor units. Arch. Phvs. 
Med. Rehah. 48:l2-\9. Jan. 1967. 

12. Bottomley, loc.cit. 

13. Dorcas, D.S.. Dunfield. V.A.. and 
Scott. R.N. Improved myo-electric 
control systems. Medical and Biolog- 
ical Engineering, 8:333-4 1 , 1 970. ^ 



The myo-electric control systems re- 
search at the Bio-Engineering Institute, 
University of New Brunswick, is sup- 
ported in part by the Department of 
National Health and Welfare, the Nation- 
al Research Council, the Workmen's 
Compensation Board (N.B.). and the 
Canadian Rehabilitation Council for the 
Disabled (N.B. Branch). 

APRIL 1971 



Basilar aneurysms 



The author describes aneurysms of the basilar artery, aspects of 
surgical intervention, and the nursing care involved. 



Marion J. Derdall 

Surgical intervention of aneurysms of 
the vertebro-basilar arterial tree has, 
until recently, presented insurmount- 
able difficulties and serious hazards. 
Consequently, while surgery of other 
intracranial aneurysms developed apace, 
the vertobro-basilar system remained 
forbidden territory. 

In the last few years, however, neuro- 
surgeons have been able to harness to 
this particular problem the skills and 
experiences accumulated over two de- 
cades of treating aneurysms in other 
locations. Refinements in anesthesia, 
with careful monitoring of hemo- 
dynamic and ventilatory aspects; the 
use of mannitol (an osmotic diuretic) 
and steroids to reduce brain bulk; 
controlled hypotension during surgery; 
and the increasing use of the operating 
microscope are some factors that have 

Miss Derdall. a graduate of Saskatoon 
City Hospital. Saskatoon. Saskatchewan, 
was Research Assistant to Dr. John 
Girvin, Clinical Neurosurgeon and 
Neurophysiologist at the University of 
Western Ontario, when she wrote this 
paper. It is adapted from a speech she 
gave in Toronto last June at the Canadian 
Association of Neurological and Neuro- 
surgical Nurses. The author expresses 
her thanks to Dr. Charles G. Drake and 
Dr. Girvin for their help in preparing 
this manuscript. 



APRIL 1971 



made posterior fossa aneurysm surgery 
possible. ' 

Incidence and etiology 

Fortunately, aneurysms in the basilar 
system are uncommon. According to 
published reports, they comprise any- 
where between 4.5 percent and 15 per- 
cent of all aneurysms diagnosed, ^ and 
they seem equally distributed between 
the se.xes. Studies on the incidence of the 
more unusual forms, such as mycotic, 
traumatic, and atherosclerotic aneur- 
ysms of this region, have not yet found 
their way into medical literature. 

As with supratentorial aneurysms, 
the controversy over the genesis of 
these lesions has not been resolved. The 
traditional theory of a congenital defect 
in the middle coat of the arterial wall 
(the media) is hotly contested by the 
proponents of the hypothesis that de- 
generative changes in the media or in- 
ternal elastic lamina, aggravated by 
hypertension and atheromatouschanges. 
are responsible. An interesting compro- 
mise is the theory that congenital defects 
in the arterial wall predispose to early 
degenerative changes and subsequent 
aneurysm formation. 

Clinical features 

An acute episode of subarachnoid 
hemorrhage usually draws attention 
to the aneurysm. Occasionally, pre- 
monitory headache or wry neck precede 
THE C/yiADIAN NURSE 49 



a major rupture. Sudden entry of blood 
into the subarachnoid space is herald- 
ed by a violent headache, nausea, 
vomiting, and changes in the sensorium. 
Photophobia, hemorrhages in the fundi, 
and a stiff neck are commonly present. 
If a lumbar puncture is performed, 
the cerebrospinal fluid is bloody and 
xanthochromic. Blood pressure is fre- 
quently elevated and focal neurological 
deficits may appear. 

Less often, aneurysms, particularly 
in the posterior circulation, manifest 
as cranial nerve palsies or, if sufficient- 
ly large, as a space-occupying lesion, 
often indistinguishable from a posterior 
fossa tumor. Other aneurysms are found 
incidentally during angiography or au- 
topsy. 

Ischemia resulting from arterial 
spasm, a phenomenon not infrequently 
seen with a ruptured aneurysm, can 
add to the morbidity and confuse the 
clinical picture by producing neurolog- 
ical deficits in areas distant from the 
site of hemorrhage. Blood dissecting 
into brain substance acts essentially 
like intracerebral hematomas, and in- 
traventricular rupture carries a grave 
prognosis. 

Blood in the cisterns around the 
base of the skull causes slowing of 
cerebrospinal fluid circulation; symp- 
toms of acute or chronic hydrocephalus 
may develop. 

Although spontaneous rupture can 
occur even in sleep, it is often associat- 
ed with straining, as in lifting, pushing, 
breath holding, and during coitus. 

Treatment 

The words of one authority on this 
subject, Dr. Charles Drake, probably 
indicate the views held by most neuro- 
surgeons about basilar aneurysm sur- 
gery. 

"The decision to operate upon a 
patient with a ruptured aneurysm de- 
serves the most careful consideration. 
50 THE CANADIAN NURSE 



Many factors are to be considered, but 
with an intimate knowledge of the case 
the question should be asked whether, 
with reasonable surety, this aneurysm 
can be obliterated without hurting the 
brain further, so that this patient will 
be the delight of his family and useful 
to the community. 

"Many cases remain unsuitable for 
early surgical treatment because of 
serious disorder of brain function from 
swelling, infarction and disruption by 
parenchymal hemorrhage. Too often 
we concern ourselves with whether 
the patient lives or dies, but even more 
tragic than death is the specter of a 
person rendered demented, or mute 
and hemiplegic. 

"Of equal importance to such a loss 
of human dignity is the burden for the 
family. A judicious waiting period, 
days or even weeks, will reveal the 
degree of brain function of which the 
patient will be capable, and a worth- 
while life can then be preserved by op- 
eration . . . ."^ 

Operative Approach 

The patient is placed in Sims' posi- 
tion for approach under the right tem- 
poral lobe. This approach may be 
altered when the aneurysm is in an 
unusual location or when there is sure 
knowledge of right cerebral dominance. 
Either the radial or brachial artery is 
cannulated to record the mean arterial 
pressure. 

The lateral position dllows easy 
access for lumbar puncture and drain- 
age of all cerebrospinal fluid after the 
bone flap has been raised. In many 
instances the resulting brain slackness 
will be all that is necessary for the ex- 
posure. However, deep, firm retraction 
of the temporal lobe may be required 
to expose the basilar bifurcation; in 
these cases, mannitol is usually given 
to lessen the need of retractor pressure, 
thereby reducing the chance of bruising 
the inferior temporal cortex. When 



there is a possibility that mannitol will 
be used, an indwelling catheter is placed 
in the patient's bladder before draping. 

Following removal of the bone flap, 
exposure is performed with the aid 
of magnification, and profound hypo- 
tension (approximately 40 to 50 mm 
Hg.) is artificially induced. Isolation and 
obliteration of the aneurysm complete 
the procedure. Aneurysms may be 
clipped, ligated, wrapped, or, less 
often, pilo-injected. 

Closure of the craniotomy deserves 
brief comment. When the operation 
has been delayed for a week and has 
proceeded uneventfully, postoperative 
edema is unusual and the dura can be 
closed and the bone flap tied in place. 
However, when edema is expected or 
when the brain is tight or swelling, the 
dura is left open and the bone flap 
placed in the bone bank for later re- 
placement.'' 

Complications 

Basilar eneurysm surgery is subject 
to all the complications found in any 
craniotomy. Clots — epidural, sub- 
dural, and intracerebral — can occur 
at any time in the postoperative course; 
bone flap infections, meningitis, cere- 
bral edema, and systemic complica- 
tions may also follow. 

Although inadequate vascular per- 
fusion is recognized as a complication 
of ruptured aneurysm without surgery, 
it is also a condition that may be pre- 
cipitated by intracranial surgery. Bot- 
terell et al noted that ischemic infarc- 
tion after surgery occurred almost 
exclusively in those persons operated 
on within one week of a "bleed." ^ They 
believe arterial spasm, affected by two 
factors, local and systemic, is implicat- 
ed. 

Local factors enhancing spasm in- 
clude trauma to the vessel wall, exces- 
sive traction, or pinching of the vessel 
if the clip is too closely applied. Athero- 

APRIL 1971 



ANTERIOR CEREBRAL 




INTERNAL CAROTID 



ANEURYSM AT 
BIFURCATION 



POSTERIOR CEREBRAL — 

ANEURYSM ON T 

TRUNK OF 
BASILAR 
ARTERY 



ANTERIOR 
INFERIOR- 
CEREBELLAR 



POSTERIOR.'' 
INFERIOR CEREBELLAR 



MIDDLE CEREBRAL 



--POSTERIOR 
COMMUNICATING 



--^^ SUPERIOR 
CEREBELLAR 



BASILAR 



VERTEBRAL 



Diagram showing the principal arteries at the base of the brain and two aneurysms-one at the 
bifurcation and one on the trunl< of the basilar artery. 



sclerotic plaques provide an additional 
variable that may contribute to local 
circulatory changes. 

Systemic variables include any 
changes that mav reduce blood flow, 
such as hypovolemia; reflex hyperten- 
sion due to anesthesia; drugs such as 
chlorpromazine, and mechanical 
changes relating to gravity, brought 
about by elevating the head. 

Allcock and Drake also consider 
arterial spasm to be the main cause of 
mortality and morbidity after intracra- 
nial surgery for aneurysms that have 
bled. 6 In addition, they believe hypo- 
thermia, in conjunction with excessive 
hyperventilation and perhaps Fluothane 
anesthesia, contribute to spasm. 

Complications specific to the clipping 
of individual arteries also occur. The 
proximal vertebral ligation may be 
followed by transient ischemic signs, 
such as hemiparesis, ataxia, dysarthria, 
and restriction of eye movements. 

Nursing care. 

The nursing care of patients with 
basilar aneurysms varies little from 
care given to patients with anterior 
circulation aneurysms. The proximity 
of vital centers, such as those control- 
ling vasomotor and respiratory function, 
to the site of the lesion and surgery must 
constantly be kept in mind. Vigilance 
in the pre- and postof)erative period is 
the rule. 

APRIL 1971 



On admission the patient is placed 
on a subarachnoid hemorrhage regimen, 
which is by no means rigid, but lays 
down some guidelines that are modi- 
fied to suit the individual patient. 

Environmental stresses appear to 
increase the chance of a subarachnoid 
hemorrhage. All activities that increase 
the patient's blood pressure are avoided. 
These include straining at defecation 
and micturition, lifting, and bending. 

Emotionally, the elimination of 
undue worry is a prime requisite for 
both the patient and his family. Careful, 
concise explanation of procedures and 
treatments prevents anxiety that comes 
from not knowing what is going to 
happen. 

The need for repeated checks of the 
patient's neurological signs is vital, 
the frequency dictated by the condi- 
tion of the patient. 



Regimen 

•The patient is admitted to a private 
room when possible, and is put on 
complete bed rest. His bed is kept 
flat, but he is allowed a small pillow. 
Bedsides are used. 

•The nurse feeds the patient, who is 
on a low residue diet. 

• No enemas or suppositories are given; 
instead, the patient takes 30 cc. of 
Magnolax and 30 cc. of mineral oil 
daily. A fracture pan is used, and 



this, or a urinal, in offered to the 
patient every four hours. 

• Male patients are shaved by the or- 
derly every second day. 

• Television is not allowed; however, 
the patient can listen to his radio at 
a low volume. 

•The patient's immediate family may 
visit him twice daily for 10 to 15 
minutes. The complete regimen and 
its importance are explained fully to 
the patient and his family. 

• A complete check of the patient's 
neurological status is made by the 
nurse hourly during the day and every 
two hours during the night. 

• The patient is discouraged from smok- 
ing, but may be allowed five cigaret- 
tes daily. 

•A sign on the patient's bed indicates 
the nursing care to be given. 

Medication 

Drugs that might alter the neurolo- 
gical signs are avoided. If they have to 
be given, familiarity with their effects 
is important. 

The choice of drugs administered 
differs from center to center, but the 
desired effect rarely varies. Amobar- 
bital 60 mg. per os in given q. 6 h. as 
a sedative; codeine 60 mg. per os or 
intramuscularly is the analgesic of 
choice. Maintenance of the patient's 
blood pressure seems to be the most 
difficult to control. At present, An- 
solysen (pentolinium tartrate), a gan- 
glionic blocking agent, is given. Amicar 
(aminocaproic acid), a fibrinolytic 
inhibitor, is given to reduce the chance 
of further bleeding. These drugs are 
discontinued the day prior to surgery. 

Preoperative Preparation 

Barring unforeseen problems arising 
from routine admission tests, carotid 
and vertebral angiography are per- 
formed shortly after admission to find 
the cause of hemorrhage. To alleviate 
emotional stress, the patient is frequently 
THE CANADIAN NURSE 51 



not told of his impending surgery until 
the morning of surger>. Naturally, the 
family is forewarned of the surger> and 
its implications. As all hair clipping is 
done after induction, a pHisoHex sham- 
poo is all that is required in the phys- 
ical preoperative preparation. 

Postoperative Care 

The first 24 hours postoperatively 
are the most crucial. If complications 
are to be dealt with effectively, time is 
of the utmost importance. Because of 
her constant contact with the patient. 
the nurse can detect postof)erati\ e 
complications immediately. 

Careful monitoring of the patient's 
neurological status is basic to all post- 
operative craniotomy patients. In 
addition, it is wise to be familiar with 
the patients preoperative status so 
that any changes in his condition can 
be interpreted intelligently. 

Cerebral edema will occur to some 
degree in all craniotomies. The prob- 
lem is to ditTerentiate between signifi- 
cant and insignitlcant swelling. Changes 
in the level of consciousness are the 
best guidelines. Initial recoverv from 
anesthesia should tlnd the patient 
alert, oriented, and aware of his envi- 
ronment. Gradual drowsiness and con- 
fusion indicate the onset of cerebral 
edema. With other signs of increased 
intracranial pressure registering, ster- 
oid therapy, mannitol, and other wa\^ 
to induce dehydration may be initiated. 

The use of .-Xrtonad to lower the 
blood pressure artificially, may result 
in fixed-dilated pupils in the immediate 
postoperative period. As the effects of 
this drug wear off. the observation of 
a unilateral paresis of the third cranial 
nerve, temporarily present due to ma- 
nipulation during surgerv. may cause 
the nurse to "hit the panic button" 
for the resident unless she has familiar- 
ized herself with the operative proce- 
dure. 

In anerial spasm. level of conscious- 

52 THE CANADIAN NURSE 



ness is the first sign to alter. Transient 
confusion appears to be the forerunner, 
rapidly followed by increasing drows- 
iness and focal disturbance of brain 
function. If the patient has had recent 
bleeding or adverse clinical findings 
prior to surgerv, the nurse should be 
prepared for rapid changes in his neu- 
rological status. Treatment is varied. 
Rheomacrodex (a plasma volume 
expander), alternated with mannitol 
and steroid therapy, are presently used. 

The future 

From a medical viewpoint, reduc- 
tion of the morbidity and mortality 
rates associated with basilar aneurysm 
surgerv appears to rest on two points: 
reducing the danger of a second or a 
third bleeding episode during the 
waiting period prior to surgery, or 
operating immediately on admission 
and eliminating postoperative arterial 
spasm. Amicar, pre\iously mentioned, 
appears to have potential in reducing 
the danger of another hemorrhage, 
but arterial spasm continues to be an 
unsolved problem. 

From the nursing standpoint, moni- 
toring devices, such as one to record 
intracranial pressure, will surely bring 
about an improvement in the nursing 
care given. Finally, continuing educa- 
tion and improved communication 
among those concerned with neurolo- 
gical and neurosurgical nursing will 
undoubtedly enhaiKe the nursing care 
of patients with aneurv^ms of the ver- 
tebro-basilar system. 

References 

1 . Drake. C.G. Further experience with 
surgical treatment of aneurv'sms of 
the basilar arterv'. J. \eurosurg. 29: 
372-391. 1968. 

2 Locksley. H.B. et al. Report on the 
cooperative study of intracranial aneur- 
N'sms and subarachnoid hemorrhages. 
J. Neurosurg. 25:6: 662-7(M. 1966. 



3. Drake. C.G. On surgical treatment of | 
ruptured intracranial aneurjsms. Clin. 
Seurosurg. 13:122-155, 1965. 

4. Drake. C.G. The surgical treatment of 
aneurvsms of the basilar arterv'. J. \ 
Seurosurg. 29:436-446. 1968. 

5. Horwitz. N.H.. Rizzoli. H.\ . Postoper- 
ative Complications in Neurosurgical ' 
Practice. Baltimore. Williams and 
WiikinsCc. 1967. pp. 83-129. 

6. Drake. On surgical treatment of rup- 
tured intracranial aneurvsms. i^' 



APRIL 19n 



The 

Canadian 
Nurse 

50 The Driveway, Ottawa 4, Canada 




^P 




Manuscripts 



The Canadian Nurse and L'infirmiere canadienne welcome 
original manuscripts that pertain to nursing, nurses, or 
related subjects. 

All solicited and unsolicited manuscripts are reviewed 
by the editorial staff before being accepted for publication. 
Criteria for selection include : originality: value of informa- 
tion to readers; and presentation. A manuscript accepted 
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accepted for publication in L'infirmiere Canadienne. 

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Bibliography 

References, footnotes, and bibliography should be limited 
APRIL 1971 



to a reasonable number as determined by the content of the 
article. References to published sources should be numbered 
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article. Information that cannot be presented in formal 
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The Canadian Nurse 

OFFICIAL JOURNAL OF THE CA-NADIAN NURSES' ASSOCIATION 

THE CANAOIAN NURSE 53 



April 12-August 30, 1971 

Four courses on coronary care nursing 
to assist registered nurses to increase 
their competency as staff nurses providing 
care for coronary heart disease patients. 
Each four-week course will accommodate 
20 nurses. Tuition fee: $200.00. For further 
information and application forms write: 
University of Toronto, Continuing Educa- 
tion Program for Nurses, 42 Queen's Park 
Cres. E., Toronto 5, Ontario. 

April 15-16,1971 

University of British Columbia, Division of 
Continuing Education, Course on Acute 
Illness for nurses practicing in acute wards 
of general hospitals. Fee: $23.00. For furth- 
er information write: Margaret S. Neylan, 
Associate Professor and Director, Univer- 
sity of British Columbia School of Nursing, 
Division of Continuing Education, Van- 
couver 8, B.C. 

April 17,1971 

Final graduation exercises. Stratford Gen- 
eral Hospital School of Nursing, to be held 
at Stratford Shakespearean Festival Thea- 
tre. All alumnae are invited to return tor a 
homecoming weekend. 

April 19-22, 1971 

Canadian Public Health Association, 62nd 
annual meeting. King Edward Sheraton 
Hotel, Toronto. For advance registration, 
information, and accommodation, write: 
CPHA Annual Meeting, 1255 Yonge Street, 
Toronto 7, Ontario. 

April 23-24, 1971 

Association of Operating Room Nurses 
National Committee on Education and 
the Association of Operating Room Nurses 
of St. Louis, Regional Institute on Operat- 
ing Room Nursing, Stouffers Riverfront 
Inn, St. Louis, Missouri. Program theme: 
"Bridging the Gap." For further information 
write: Mrs. Mary Davern, Registration 
Chairman, Box 812, Bridgeton, Mo. 63044, 
U.S.A. 

April 29-May 1, 1971 

Annual Meeting, Registered Nurses' 
Association of Ontario, Royal York Hotel 
Toronto, Ontario. 

May 3-14, 1971 

Intensive course on "Analysis of the Pro- 
cess of Psychiatric Nursing," to be con 
ducted five days a week at Sunnybrook 
Hospital, Toronto, Enrollment is limited 
to 10 nurses working in the field of psy- 
chiatric nursing. Fee: $125.00. For further 
information and application forms write: 

54 THE CANADIAN NURSE 



Continuing Education Program, University 
of Toronto, 47 Queen's Park Crescent 
East, Toronto 5, Ont. 

May 4-7, 1971 

Workshop on Test Construction for Teachers 
in Nursing Education to be conducted by 
Professor Vivian Wood. Tuition fee, includ- 
ing meals and accommodation: $120.00. 
For further information contact: Summer 
School and Extension Department, The 
University of Western Ontario, London 72. 

May 9-12, 1971 

National League for Nursing and National 
Student Nurses' Association, annual con- 
vention, Dallas Memorial Auditorium and 
Convention Hall, Dallas, Texas, U.S.A. 

May 10-28, 1971 

Three-week intensive course in Developing 
Human Resources for Improved Nursing 
Care, offered for nurses who take respon- 
sibility for the work of others. It is designed 
to assist the nurse to improve her skills in 
fostering development of the abilities of 
individuals and work groups giving nursing 
care. For further information write: Continu- 
ing Education Program for Nurses, Univer- 
sity of Toronto, 47 Queen's Park Crescent, 
Toronto 5, Ont. 

May 11-14, 1971 

Alberta Association of Registered Nurses, 
annual meeting, Banff Springs Hotel, Banff, 
Alberta. 

May 17-22, 1971 

Three one and one-half day institutes, 
sponsored by Memorial University of New- 
foundland School of Nursing and the Asso- 
ciation of Registered Nurses of Newfound- 
land. Topic: The Expanded Role of the 
Nurse. Guest speaker: Martha Rogers, 
Head, Division of Nursing Education of 
New York. Obtain registration forms from 
your association office. 

May 19, 1971 

Catholic Hospital Conference of Ontario, 
nursing committee, annual meeting. King 
Edward Hotel, Toronto, Ontario 

May 19-20, 1971 

New Brunswick Association of Regis- 
tered Nurses, annual meeting. Holiday Inn, 
Saint John, N.B. Convention theme: "Pat- 
terns of Health Care in N.B." 

May 26, 1971 

Registered Nurses' Association of British 
Columbia, 59th annual meeting, Bayshore 
Inn, Vancouver, B.C. 



May 26, 1971 

Saskatchewan Registered Nurses' Asso- 
ciation, annual meeting, Bessborough 
Hotel, Saskatoon, Saskatchewan. 

May 26-29, 1971 

Reunion of The Montreal General Hospital 
School of Nursing graduates to celebrate 
the hospital's 150th anniversary. Graduates 
should send addresses to: Miss Phyllis 
Walker, The Montreal General Hospital 
(Dept. of nursing), Montreal 109, P.Q. 

May 30-|une 1, 1971 

Manitoba Association of Registered nurses, 
annual meeting, Dauphin, Manitoba. 

May30-June11,1971 

A concentrated two-week course to provide 
basic information for individuals dealing 
with problems related to misuse of alcohol 
and other drugs, sponsored by Addiction 
Research Foundation, to be held at the 
University of Guelph, Guelph, Ont. Enroll- 
ment limited to 100. For further information 
write: Director, Summer Courses, Addic- 
tion Research Foundation, Education Di- 
vision, 33 Russell St., Toronto 4, Ontario. 

June 2-5, 1971 

Reunion of Plummer Memorial Public 
Hospital School of Nursing graduates to 
celebrate the school's final graduation. 
Those interested should write: Mrs. Dor- 
othy Janstrom (Williams), 49 Promenade 
Dr., Sault Ste Marie, or Mrs. Dorothy Sy- 
mes (Rowe), 129 Princess Cres., Sault 
Ste Marie, Ontario. 

June 10-11, 1971 

Symposium on Metabolism and Disease, 
sponsored by the Food and Drug Director- 
ate, Department of National Health and 
Welfare, Talisman Motor Inn, Ottawa. 

June 15-17, 1971 

Registered Nurses' Association of Nova ^ 
Scotia, annual meeting. Nova Scotia Agri- 
cultural College, Truro, Nova Scotia. 

June 17-19, 1971 

Canadian Association of Neurological 
and Neurosurgical Nurses, second annual 
meeting, held in conjunction with the Ca- 
nadian Congress of Neurological Sciences, 
St. John's, Newfoundland. For further 
information contact the Secretary: Mrs. 
Jacqueline LeBlanc, 5785 Cote des Nei- 
ges, Montreal 290, Quebec. 

May 13-19,1973 

International Council of Nurses, 15th Quad- 
rennial Congress, Mexico City, Mexico. ^ 

APRIL 19711 



research abstracts 



Khairat, Lara. An exploratory study 
of the effectiveness of the parent 
education conference method on 
child health. Vancouver, B.C., 1970. 
Thesis (M.Ed.) U. of British Colum- 
bia. 

In the study that examined the child 
health conference as an individual 
method of adult education, evaluations 
were made of both the nurse instructor 
and parent-participant relationships 
and the gains made by parent partici- 
pants in their knowledge of general 
health information, developmental 
milestones, and mother-infant relation- 
ships during their period of attendance 
at the conferences. It was hypothesized 
that there would be no statistically 
significant mean equivalences between 
the first and final test scores for the 32 
parents who comprised the study pop- 
ulation. The hypotheses were rejected 
with values of t which were significant 
beyond the 0.001 level. 

Despite the significant gains re- 
corded, it would appear that a number 
of major factors presently limit the 
conferences' efficiency in providing 
optimal conditions under which learn- 
ing may occur. First, an assessment 
of the educational needs or expectations 
of each parent is not undertaken at the 
beginning of each conference, and 
learning objectives appropriate to 
each individual participant are not 
set up. 

Second, the conference does not 
presently specify educational objectives 
in terms of desired behaviors and, there- 
fore, health teaching is not only relegat- 
ed a more minor role, but participants 
are forced to become mere passive 
recipients of information. Third, the 
conference may not always reach its 
present broad goals because appoint- 
ments made by the nurse for the parent- 
participant to return for further dis- 
cussions may be broken. 

Although it was felt that the research 
instruments used in this study met to 
some degree the requirements for which 
they were constructed, they could un- 
doubtedly have been much more ef- 
fective measuring devices had steps 
been taken to increase their reliability, 
validity, objectivity, comprehensi- 
veness, and differentiation. Moreover, 
rating scale errors could have been 
minimized had nurses been trained 
in their proper use. 
APRIL 1971 



Smith, Ethel Margaret. Concerns of 
mothers participating in the care of 
their children hospitalized for minor 
surgery in a day care unit. Vancou- 
ver, B.C., 1970. Thesis (M.Sc.N.) 
U. of British Columbia. 

At present very little is known of the 
various problems mothers experience 
when their children are admitted to a 
day care unit, in terms of the increased 
responsibility placed upon them for the 
preparation of their children and their 
care at home following discharge. The 
purpose of this study was to identify 
some of the major concerns expressed 
by mothers who participated in a day 
care unii in a children's hospital in 
Vancouver. 

A sample of 20 mothers was selected. 
The kinds of nursing activities in which 
they participated in the unit were as- 
sessed and rated by a participation 
scale. The data were collected by the 



MOVING? 
BEING MARRIED? 

Be sure to notify us six weeks In advance, 
otherwise you will likely miss copies. 



> 



Attach the Label 

From Your Last Issue 

OR 

Copy Address and Code 
Numbers From It Here 



< 



NEW (NAME) /ADDRESS: 



Street 



City 



Zone 



Prov./State Zip 

Please complete appropriate category: 

I I I hold active membership in provincial 
nurses' assoc. 



reg. no./perm. cert./ lie. no. 

I I I am a Personal Subscriber. 

MAI LTD: 

The Canadian Nurse 

50 The Driveway 
OTTAWA 4, Canada 



researcher, who took on the role of 
participant observer in the day care 
unit. Field notes were written on the 
mothers while they were in the unit, 
and post-hospital interviews were 
recorded approximately one week to 
10 days following discharge. 

The participation scales, field notes, 
and post-hospital interviews were ana- 
lyzed, and the frequency and percent- 
ages of the expressed concerns deter- 
mined. Seventy percent of the mothers 
in the study group needed help to assist 
with the care of their children in the 
unit. Concerns expressed by the mothers 
were centered on the notion of time 
and a desire for information related 
to the child's diagnosis, the anesthetic 
used, and the operation performed. 
Postoperatively, they expressed con- 
cerns related to symptoms caused by 
the anesthetic, operation, or examina- 
tion. They seemed particularly appre- 
hensive about the anesthetic and its 
possible effects on the children. 

Seventy-five percent of the mothers 
had had previous experience with the 
hospitalization of their children. This 
factor seemed most characteristic of 
the group and influenced their partici- 
pation in the day care activities. Only 
two mothers had prior knowledge of 
the day care unit and they participated 
independently, requiring little assistance 
from the nurse. 

Ninety percent of the mothers were 
satisfied with the day care experience. 
Two mothers were unhappy about the 
arrangements and would have preferred 
to have their children remain in hos- 
pital a few days postoperatively. These 
mothers would have benefited from a 
home visit by a nurse. The remaining 
90 percent stated they did not feel they 
needed a visit from a nurse postopera- 
tively. All mothers appreciated a tele- 
phone call from the hospital following 
surgery. The mothers contacted their 
doctors if problems arose at home. They 
felt the instructions they received by 
mail prior to admission were adequate. 

The success of surgical day care 
units for children is dependent upon 
the interest and support of parents. 
Mothers can prepare their children for 
surgery and cope with post-hospital 
care, if they receive help and support 
from the nursing staff. Mothers whose 
children have been treated in a day care 
unit are most enthusiastic about this 
type of hospital care. ^ 

THE CANADIAN NURSE 55 




Cassette Recorderl Player 



Portable Cassette Recorder/Player 

The first Canadian-built and Canadian- 
designed portable classroom cassette 
recorder/player — Model CR5-C — 
has been introduced by the Rheem 
Califone division of J.M. Nelson Elec- 
tronics (Rheem-Roberts of Canada). 
Its main advantage is convenience and 
time saved usmg mstant-loadmg cas- 
settes. The Califone Model CR5-C is 
built to take the wear and tear of every- 
day classroom use, and features "Slide 
Pot" controls for tone, volume and 
microphone volume setting, automatic 
gain control, and the use of standard 
"1/4" jacks throughout. 

Further information may be obtain- 
ed by writing to J.M. Nelson Electron- 
ics, 1305 Odium Drive, Vancouver 6, 
British Columbia. 

Red Cross Society 

Medical Langage Communicator 

This 24-page booklet is intended to 
help patients unable to speak English 
or French to communicate with med- 
ical staff. 

The left-hand page under each of 
the 10 languages listed is for the phy- 
sician's use when asking questions of 

56 THE CANADIAN NURSE 



the patient. The 22 basic questions 
have opposite them the pertinent trans- 
lation. The right-hand page contains 
26 useful statements and requests, with 
translation, to allow the patient to 
communicate with the doctor or nurse. 
The foreign-language material in 
this booklet is derived from the doctor- 
patient language car^s compiled by the 
British Red Cross Society. 







^H 


Cheque out 1 
a crippled child 1 


today. ■ 


See what your dollars can do. H 

Support Easter Seals. 1 







In response to a felt need, the book- 
let was produced in English and in 
French by Parke-Davis and Company, 
through the cooperation of the Cana- 
dian Red Cross Society. 

For copies of the Medical Language 
Communicator write to Parke-Davis 
and Company, 5190 Cote de Liesse 
Road, Montreal, Quebec. 

Multicolor Transparencies 
for Overhead Projection 

The Patient and Circulatory Disorders 
contains 54 transparencies with 99 
overlays and includes carrying case and 
comprehensive instructor's guide. 

Unit 1 — Normal anatomy and phys- 
iology ( 1 1 transparencies, 24 overlays) 

Unit 2 — Special tests and proce- 
dures (10 transparencies, 14 overlays) 

Unit 3 — The patient and coronary 
disease (33 transparencies, 61 over- 
lays) 

A detailed brochure, illustrating 
each transparency and overlay in each 
unit may be requested from the J.B. 
Lippincott Company of Canada Ltd., 
60 Front Street West, Toronto 1, 
Ontario. 

The Patient and Fluid Balance contains 
64 transparencies with 158 overlays 
with carrying case and instructor's 
guide. 

Unit 1 — The state of equilibrium: 
normal physiology ( 1 1 transparencies, 
26 overlays); 

Unit 2 — Disequilibrium, Part A: 
Altered physiology (16 transparencies, 
48 overlays). Part B: Clinical applica- 
tion (17 transparencies, 35 overlays); 

Unit 3 — Fluid therapy (20 trans- 
parencies, 35 overlays). 

A detailed brochure, illustrating 
each transparency and overlay in each 
unit may be requested from J.B. Lip- 
pincott Company of Canada Ltd., 60 
Front Street West, Toronto 1 , Ontario. 

FILMS 

To Inner Space (16 mm. sound, color, 
13 min.) was produced by Crawley 
Films for Hoffman-LaRoche, Canada, 
with Dr. Edward Atack of Ottawa as 
consultant. 

This is the case history of a young 
girl suffering from a neuromuscular 
disease. The film portrays the complex- 
ity of the human body and shows what 
happens when it malfunctions. It deals 

APRIL 1971 



with the role played by drugs and the 
care taken In producing pharmaceutical 
agents, including laboratory tests on 
animals. 

The distributor of this film is Hoff- 
man-LaRoche, 1956 Bourdon Street, 
Montreal 378, Quebec. 

Films available on loan from Abbott 
Laboratories Limited, P.O. Box 6150, 
Montreal, Quebec: 

Cell Division and Growth ( 1 3 minutes, 
sound) shows, in a few minutes, sev- 
eral days of cell life. The activity of 
living tumor cells is shown under 
microscope at nearly 300 times normal 
speed. Cells are seen moving in amoe- 
boid fashion, developing pseudopods, 
growing, aligning chromosomes, and 
dividing when mature. 

That They May Live (27 minutes, 
sound) instructs the layman on the 
safest and most efficient means of 
mouth-to-mouth artificial respiration 
by integrating the message into an en- 
tertaining story. Almost all areas where 
accident victims might need on-the- 
spot artificial respiration are dealt with. 



tion and heart massage. It won the 
San Francisco Film Festival Silver 
Award. 

The Hospital Pharmacy Team (20 
minutes, sound), of interest to nursing 
groups as well as pharmacists, is essen- 
tially a career placement film on the 
duties of hospital pharmacists. It was 
directed by H. Smythe, director of 
pharmaceutical services, Ottawa Civic 
Hospital, Ottawa. 

Films available on loan from Canadian 
Film Institute, 1762 Carling Avenue, 
Ottawa 13, Ontario: 
A Half Million Teenagers (1969, 
sound, color, 16 minutes, produced by 
Churchill Films, USA. Purchase source 
in Canada: Educational Film Distrib- 
utors, Ltd., Toronto, Ontario). 

Each year syphilis and gonorrhea 
claim a half million teenagers as vic- 
tims. The film shows how these dis- 
eases are contracted and their prog- 
ress if untreated. It also stresses that 
both diseases can be cured, and con- 
cludes with a series of questions design- 
ed to stimulate discussion. 



Pulse of Life (27 minutes, sound), of Keep Off the Grass (1970, sound, 

particular interest to first-aid groups color, 12 minutes, produced by More- 

and teachers, shows the most recent land-Latchford Productions Limited, 

methods of mouth-to-mouth resuscita- Toronto, Ontario). 



This film shows a young girl in 
conflict between parental values and 
loyalty to fellow teenagers. She has 
bought grass with money pooled by 
her teenage friends and her mother 
discovers the cigarettes. The mother 
has the girl destroy the cigarettes and 
permits her to repay her friends from 
iier allowance. The friends want to buy 
more grass. Open ended, the film pro- 
vides material for discussion. 

VD: A Call to Action (1969, sound, 
color, 27 minutes, produced by John 
G. Fuller in cooperation with the Mas- 
sachussetts Division of Communicable 
and Veneral Diseases, Department of 
Public Health. Underwritten by As- 
sociation Films, New York. Purchase 
source in Canada is Association In- 
dustrial Films, Toronto, Ontario). 

Diane Champagne, a nurse epidem- 
iologist of Fall River, Mass. and 26 
others in the state are engaged in find- 
ing the sources of VD infection. Pa- 
tients are interviewed to trace their 
sexual contacts, visits are made to a 
bar to locate a woman who may have 
syphilis, information is gathered from 
a private physician, and current cases 
are discussed with her supervisor. 
Stress is made that anyone can get VD 
and that the epidemic is a real one, 
needing much cooperation in every 
community. ij" 




has received 

URGENT 

requests for 

NURSES 

to work in 

INDIA 

and 

COLOMBIA 



CUSO health department has high priority requests 
for as many as 30 nurses for postings in India and 
Colombia. A few RNs with only one year's 
experience can be placed, but the real need is for 
nurses with at least two years' experience. Following 
are typical positions available for BScNs, BNs, RNs 
with post-basic diplomas and RNs with experience: 

Public Health nursing / teaching in schools for 
nursing auxiliaries / teaching at both diploma and 
baccalaureate level / ward administration and 
clinical instruction in various specialties / 
operating-room nursing / family planning 

TERMS OF SERVICE: In addition to the 
professional qualifications a CUSO assignment calls 
for such personal qualities as maturity, initiative, 
common sense, adaptability and sensitivity. 

All assignments are for two years. Most salaries are 
paid at approximately local rate by the overseas 
employer. CUSO provides training, return 
transportation, medical and life insurance. 

Next training course begins early August. For further 
information write NOW to: CUSO Health 
Department, 151 Slater Street, Ottawa 4. Ontario. 



APRIL 1971 



THE CANKVDIAN NURSE 57 



accession list 



Publications on this list have been 
received recently in the CNA library 
and are listed in language of source. 

Material on this list, except Reference 
items may be borrowed by CNA mem- 
bers, schools of nursing and other in- 
stitutions. Reference items (theses, 
archive books and directories, almanacs 
and similar basic books) do not go out 
on loan. 

Requests for loans should be made 
on the "Request Form for Accession 
List" and should be addressed to: The 
Library, Canadian Nurses' Association, 
50 The Driveway. Ottawa 4. Ontario. 

No more than three titles should be 
requested at any one time. 



BOOKS AND DOCUMENTS 

1. An abstract for action. Jerome P. Li- 
paught, director. Toronto, McGraw-Hill 
for National Commission for the Study of 
Nursing and Nursing Education, 1970. I67p. 

2. Administration in nursing. 2d. ed. by 
Mary D. Shanks and Dorothy A. Kennedy. 
Toronto, McGraw-Hill, 1970. 324p. 

3. Basic concepts in anatomy and physiol- 



ogy; a programmed presentation. 2d. ed. 
St. Louis, Mosby, 1970. 157p. 

4. Canadian almanac and directory. Toronto. 
Copp Clark, 1971. 91 2p.R 

5. The doctor's shorthand by Frank Cole. 
Toronto, Saunders, 1970. 179p. 

6. Essentials for the technical writer by 
Hardy Hoover. Toronto, Wiley, 1970. 216p. 

7. Fifty years a Canadian nurse; devotion, 
opportunities and duly by Rahno M. Bea- 
mish. New York, Vantage Press, 1970. 344p. 

8. Five patients; the hospital explained by 
Michael Crichton. New York, Knopf, 1970. 
231 p. 

9. Fundamentals of otolaryngology, a text- 
book of ear, nose and throat diseases. 4th ed. 
by Lawrence R. Boies et al. Philadelphia. 
Saunders, 1964. 553p. 

10. Health and healing by D. Naegele, 
compiled and edited by Elaine Gumming. 
San Francisco, Jossey-Bass, 1970. 122p. 

11. Helping the stroke patient to speak by 
Kingdon-Ward. London, Churchill, 1969. 
156p. 

12. Interpersonal processes in nursing ease 
histories by Lois Jean Davitz. New York, 
Springer, 1970. 142p. 

13. Life with the mentally sick child; the 
daily care of mentally sick children in hos- 
pitals and at home 1st. ed. by Phyllis R. 
Lacey. Toronto, Pergamon Press, 1969. 77p. 

14. Medical action for mental health prob- 
lems of childhood and youth; Proceedings 
of a conference held in Ottawa, Ont. March 
11-13,1970. Ottawa, Canadian Medicai 



Association, Communications and Infor- 
mation Dept., 1970. 196p. 

15. Membership directory. Chicago, Amer- 
ican Library Association, 1970. 259p. R 

16. Monique I'infirmiere; photographies 
et texte par Genevieve Rouche-Gain. Paris. 
Fernand Nathan. 1970. Iv. (Les femmes 
travaillent) 

17. The nursing and management of skin 
diseases; a guide to practical dermatology 
for doctors and nurses 3d. ed. by D.S. Wil- 
kinson. London, Faber and Faber, 1969. 
403p. 

18. Orientation to the two-year college; a 
programmed text by Richard W. Hostrop. 
Homewood. 111. Learning Systems: Cana- 
dian distribution through Irwin Dosey Ltd., 
Georgetown, Ont., 1970. 205p. (Irwin pro- 
grammed learning aid series) 

19. Orthopedic nursing; a programmed 
approach by Nancy A. Brunner. St. Louis, 
Mosby, 1970. 173p. 

20. Pediatric surgery for nurses 1st ed. 
edited by John G. Raffensperger and Ro- 
sellen Bohlen Primrose. Boston, Little Brown, 
1968. 327p. 

2 1 . Professional organizations in the Com- 
monwealth edited by James Currie. London, 
Published for the Commonwealth Foun- 
dation by Hutchison, 1970. 5 11 p. 

22. Les recettes de maman; collection fem- 
me dirigee par Nicole Germain. Montreal, 
Editions de IHomme, 1970. 168p. 

23. The roles of psychiatric nurses in com- 
munity mental health practice edited by 



MY VERY OWN 

STETHOSCOPE ? 

— but of course! 

ASSISTOSCOPE* was 

designed with the 
nurse in mind. 

ASSISTOSCOPE* gives 
you the acoustical 
perfection of the 
most expensive 
stethoscopes. 

ASSISTOSCOPE ''^ is available with black or 
hospital-white tubing and ear pieces with the slim-fit 
sonic head which slips easily under blood pressure cuffs 
or clothing. 

Ord0r fro/nf 
tCheck with your Director f 

::rrcrbur w winley-morrb company im 

USirrOSCOPE It AA *UI><IC*L INSTRUMENTt DIVIIION 

special group prices, ^A iioiit«e«l is auEicc 

*TRAOE MARK 




UNIVERSITY OF BRITISH COLUMBIA 

SCHOOL OF NURSING 

DEGREE PROGRAMMES 

Baccalaureate — basic students 

— registered nurses 
This course for both groups of students leads to 
the B.S.N, degree, and prepares the graduate for 
public health as well as hospital nursing positions. 

Master's 

For qualified baccalaureate nurses leading to the 
degree of M.S.N. This course, two years in length, 
prepares the graduate for leadership roles in nurs- 
ing with emphasis on clinical expertise. 

DIPLOMA PROGRAMME (Nursing B) 

Community Health Nursing — for registered 
nurses — psychiatric nursing required prere- 
quisite. 

Early applications are requested — 
March 1 for M.S.N., May 1 for diploma, 

June 30 for baccalaureate. 

For information write to: 

The Director 

SCHOOL OF NURSING, UNIVERSITY OF B.C. 

Vancouver 8, B.C. 



58 THE CANADIAN NURSE 



APRIL 1971 



Next Month 
in 



The 

Canadian 
Nurse 



• Young Diabetics Can 
Enjoy Camp, Too 

• Nurses in Prison 

• A Community Clinic 
Where People Count 




^^:p 



Photo credits for 
April 1971 

United Nurses. Inc., 
Montreal, p. 12 

United Press International, 
Ottawa, p. 14 

Crombie McNeill Photography, 
Ottawa, pp. 34-38 

Dept. National Health & 
Welfare. Ottawa. Photo 
of Dr. Heidgerken. p. 35 

Miller Photo Services, 
Toronto, p. 43 

University of New Brunswick, 
Fredericton, pp. 47, 48 



Gertrude A. Stokes. New York, Maimonides 
Medical Center, Community Mental Health 
Center, 1969. 152p. 

24. So. you're going to the hospital; what 
eveiy patient should know by James Gra- 
ham. St. Louis. Mo.. Warren H. Green. 
1968. I63p. 

PAMPHLETS 

25. Continuity of care — can or should the 
nurse innovate change? New York, National 
League for Nursing for Nursing Advisory 
Service of NLN-NLTRDA, 1970. 20p. 

26. Public Affairs Committee. Pamphlets. 
New York. 

no. 299 Personality "plus" through diet 
by Charles Glen King. 1960. 20p. 

27. no.314 Check-ups: safeguarding your 
health by Michael H.K. Irwin. 1961. 18p. 

28. no.315 You and your hearing by Nor- 
ton Canfield. 1961. 20p. 

29. no.318 Mental aftercare; assignment 
for the sixties by Emma Harrison. 1961. 28p. 

30. no. 333 Pathology tests look into your 
future by Thomas M. Petry and Alyce Mo- 
ran Goldsmith. 1962. 16p. 

3L no. 339 Parents' guide to children's 
vision by James R. Gregg. 1963. 20p. 

32. no.345 Caring for your feet by Herbert 
C. Yahraes. 1963. 28p. 

33. no.347 A full life after 65 by Edith M. 
Stern. 1963. 28p. 

34. no.350 Right from the start; the im- 
portance of early immunization by Judy 
Graves. 1963. 27p. 

35. no.352 Serioids mental illness in chil- 
dren by Harry Milt. 1963. 28p. 

36. no. 353 Your new baby by Ruth Carson. 
1963. 20p. 

37. no.353S Breastfeeding by Audrey Palm 
Riker. 1964. I6p. 

38. no. 356 Family therapy — help for trou- 
bled families by George Thorman. 1964. 20p. 

39. no.361 Smoking — the great dilemma 
by Ruth Brecher and Edward Brecher. 1964 
28p. 

40. no.364 Overweight — a problem foi 
millions by Michael H.K. Irwin. 1964. 20p. 

41. no. 368 How to gel good medical care 
by Irwin Block. 1965. 28p. 

42. no.372 Your health is your business 
by Harry J. Johnson. 1965. 20p. 

43. no.375 What you should know about 
educational testing by J. McV. Hunt. 1965. 
28p. 

44. nQ.376 Nine monlfis to get ready; the 
importance of prenatal care by Ruth Carson 
1965. 20p. 

45. no. 379 X-ray — vanguard of modern 
medicine by Theodore Berland. 1965. 28p. 

46. no.439 Cigarettes — America's no.! pub- 
lic health problem by Maxwell S. Stewart. 
1969. 24p. 

47. no.452 How to help the alcoholic by 
Pauline Cohen. 1970. 24p. 

48. Standards for library service in health 
care institutions. Chicago. American Library 
Association, Hospital Library Standards 
Committee, 1970. 25p. 

49. Submission to the Study Committee on 
Nursing Education. Fredericton. New 



i \ 

Busy, busy 
little fingers. 
Busily spreading 
pinworms. 




Depend upon 

m[M](Q)WDR{] 

(pyrvinium pamoate Frc 

to eliminate 
pinworms witti 
a singie dose 



Early detection, and treatment with 
Pamovin, can bring the usual unpleasant 
course of pinworms to an abrupt halt. 

It has been shown' that single-dose 
treatment with pyrvinium pamoate 
achieves an overall cure rate of 
96 per cent. 

In the family or in institutions, pyrvinium 
pamoate (PAMOVIN) offers the advantages 
of "low cost, ease of administration, 
and effectiveness."' 

Dosage: for both children and adults, a single 
dose of 1 tablet or 1 teaspoonful for every 
22 lbs. of body weight. 

Cautions: Occasionally, nausea, vomiting or 
gastrointestinal complaints may be encoun- 
tered but are seldom a problem on such 
short-term treatment. Stools may be coloured 
red. Suspension will stain clothing and fabrics. 

PAMOVIN Tablets of 50 mg. (red, film-coated), 
boxes of 6, and bottles of 24 and 100. 
Suspension (red), 50 mg. per 5 ml. teaspoonful, 
bottles of 30 ml., 4 and 16 f1. 02. 

References: 1. Beck, J. W.,Saavedra, D., 
Antell, G. J. and Tejeiro, B.: Am. J. Trop. Med. 
8:349, 1959. 2. Sanders, A. I. and Hall, W. H.: 
J. Lab. & Clin. Med. 56:413, 1960. 

Full intormalion on request. 



® 



3my^ 



CMAMLKS K rMOaST « CO. KMKLJMD IMONTmAU 



APRIL 1971 



THE CAf^DIAN NURSE 59 



accession list 



Brunswick Association of Registered Nurses, 
1970. 37p. 



GOVERNMENT DOCUMENTS 

Canada 

50. Conseil Economique. Les diverges for- 
mes de la croissance. Ottawa, Imprimeur 
de la Reine, 1970. 119p. (Its septieme ex- 
pose annuel) 

51. Dept. of National Health and Welfare. 
Income security for Canadians. Ottawa. 
Queen's Printer, 1970. 60p. 

52. Parliament. Senate. Special Committee 
on Mass Media. Report. Ottawa, Queen's 
Printer. 1970. 3v. 

53. Public Service Commission. Se.x and 
the public .service by Kathleen Archibald. 
Ottawa, Queen's Printer, 1970. 218p. 

54. Royal Commission on Bilingualism 
and Biculturalism. Canadian history text- 
hooks: a comparative study by Marcel Tru- 
del and Genevieve Jain. Ottawa, Queen's 
Printer, 1970. 149p. (Its Study no. 5) 

55. Royal Commission on the Status of 
Women. Report. Ottawa, Queen's Printer, 
1970. 488p. 

56. Task Force on Labour Relations. A 



study of the effects of the $1 .25 minimum 
wage under the Canada labour (standards) 
code by Mahmood A. Zaidi. Ottawa, Queen's 
Printer, 1970. 163p. (Its Study no. 16) 
United States 

57. National Center for Chronic Disease 
Control. Heart Disease and Stroke Pro- 
gram. Guidelines for coronary care unit. 
Wash.. U.S. Gov't Print. Off., 1969. 23p. 
(Public Health Service Publication no. 1824) 

58. National Medical Audio-visual Centre. 
Videotapes available for duplication. At- 
lantic, Georgia, 1970. 53p. 

STUDIES DEPOSITED IN 

CNA REPOSITORY COLLECTION 

59. Achieving self-care: a shared respon- 
sibility by Marie Holaday. Montreal, 1970. 
106p. (Thesis (M.Sc.(App.)) - McGill) R 

60. Le comportenient respectif de I'infir- 
miere, des mastectomisees et des amputes 
d'un membre durant les changements de 
pansements par Louise Levesque. Montreal. 
1970. 95p. (Thesis (M.Sc.(App.)) - McGill) R 

61. A descriptive study: permitting choice 
in nursing the aged patient is inconsistent 
with the nurse's goals in the general hos- 
pital by T. Rose Murakami. Montreal, 1970, 
60p. (Thesis (M.Sc.(App.)) - McGill) R 

62. Etude des effets de I'intrevue initiale 
entre I'infirmiere et le malade mental ad- 
mis dans un service de psychiatric par Can- 
dide Gravel. Montreal, 1970, 163p, (Thesis 
(MN) - Montreal) R 



63. A follow-up study of the graduates of a 
selected hospital school of nursing, 1957- 
1962 by Sister St. Cuthbert Brownrigg. 
Washington. 1964. 60p. (Thesis (M.S.N.) - 
Catholic University of America) R 

64. Nursing in fleeting encounters by Mar- 
ion Kerr. Montreal, 1970. 76p. (Thesis 
(M.Sc.(App.))- McGill) R 

65. Nursing papers vol. 2, no.2 Montreal, 
McGill University School of Graduate 
Nurses, 1970. 22p. Contents. - Response 
to the Task Force reports. - Postpartal inter- 
action. - Looking at baccalaureate education 
and practice. 

66. Selection and success of nursing can- 
didates: a critical survey by Anne Elizabeth 
Willett et al. Toronto. St. Michael's School 
of Nursing, 1970. 92p. R 

67. A study of the characteristics of the 
nurse-aged patient interaction process by 
Anita L. Cabelli. Montreal, 1970. 104p. 
(Thesis (M.Sc.(App.)) - McGill) R 

68. A study of mother-nurse interactions 
during feeding time when the mother is 
feeding her baby by Amelia Pinsent. Mont- 
real, 1970. 67p. (Thesis (M.Sc.(App.)) - 
McGill) R 

69. A subjective study of the attitude of 
public health nurses employed in a gener- 
alized public health agency toward providing 
service to patients with mental or emotional 
problems by Pauline J. Siddons. Victoria, 
Health Branch, Dept of Health Services and 
Hospital Insurance, 1970. 8Ip. R ^ 



Request Form for "Accession List" 
CANADIAN NURSES' ASSOCIATION LIBRARY 

Send this coupon or facsimile to: 

LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario 

Please lend me the following publications, listed in the issue of The 

Canadian Nurse, or add my name to the waiting list to receive them when available: 

Item Author Short title (for identification) 

No. 



Requests for loans will be filled in order of receipt. 

Reference and restricted material must be used in the CNA library. 

Borrower Registration No. 

Position 

Address 

Date of request 



60 THE CANADIAN NURSE 



APRIL 1971 



DO YOU 

WANT TO HELP 

YOUR PROFESSION? 

Then till out and send in the form below 



REMITTANCE FORM 
CANADIAN NURSES' FOUNDATION 

50 The Driveway, Ottawa 4, Ontario 

A contribution of $ payable to 

the Canadian Nurses' Foundation is enclosed 
and is to be applied as indicated below: 

MEMBERSHIP (payable annually) 



Nurse Member — 


Regular $ 2.00 




Sustaining $ 50.00 




Patron $500.00 


Public Member — 


Sustaining $ 50.00 




Patron $500.00 


BURSARIES $ 


RESEARCH $ 


MEMORIAL $ 


in memory of 


Name and address of person to be notified of 
this gift 




REMIHER 


Address 


(Print name in full) 


Position 


Employer 



N.B.: CONTRIBUTIONS TO CNF 
ARE DEDUCTIBLE FOR INCOME TAX PURPOSES 



Index 

to 

advertisers 

ApriM971 



Abbott Laboratories Ltd 8. 9 

Baxter Laboratories of Canada 2 1 

Burroughs Wellcome & Company 

(Canada) Limited 31 

Clinic Shoemakers 2 

Charles E. Frosst&Co 22.59 

Hollister Limited 18 

LV. Ometer. Inc 23 

Johnson & Johnson Limited Cover III 

LaCross Uniform Corp 25 

J.B. Lippincott Company 

of Canada Limited 19.27 

C.V. Mosby Company. Ltd 10 

Nursing Opportunities 15 

Octo Laboratory Ltd 32 

J.T. Posey Company 6 

Reeves Company Cover IV 

W.B. Saunders Company Canada Ltd I 

Julius Schmid of Canada Ltd 5 

Scholl Mfg. Co. Limited 17 

Smith & Nephew Limited 1 3 

White Cross Shoes 26 

White Sister Uniform, Inc Cover II 

Winley-Morris Company Ltd 58 

Advertising 

Manager 

Ruth H. Baumel, 

The Canadian Nurse 

50 The Driveway 

Ottawa 4, Ontario 

Advertising Representatives 
Richard P. Wilson 
219 East Lancaster Avenue 
Ardmore, Penna. 19003 

Vance Publications, 
2 Tremont Crescent 
Don Mills, Ontario 

Member of Canadian 

Circulations Audit Board Inc. 



APRIL 1971 



THE CANADIAN NURSE 79 



PROVINCIAL ASSOCIATIONS OF REGISTERED NURSES 



Alberta 

Alberta Association of Registered Nurses, 
10256 — 1 12 Street, Edmonton. 
Pres.: M.G. Purcell; Pres.-Elect: R. Erick- 
son; Vice-Pres.: D.E. Huffman, A.J. Prowse. 
Committees — Niirs. Serv.: G. Clarke; 
Niirs. Ediic: G. Bauer; Staff Ni4rses: L.A. 
Meighen; Superv. Nurses: L. Bartlett; Soc. 
& Econ. Welf.: I. Mossey. Provincial Office 
Staff — Pub. Rel.: D.J. Labelle; Employ. 
Rel.: Y. Chapman; Committee Advisor: 
H. Cotter; Registrar: D.J. Price; Exec. Sec: 
H.M. Sabin; Office Manager: M. Garrick. 

British Columbia 

Registered Nurses' Association of British 
Columbia, 2130 West 12th Avenue, Vancou- 
ver 9. 

Pres.: M.D.G. Angus; Past Pres.: M. Lunn; 
Vice-Pres.: R. Cunningham, A. Baumgart; 
Hon. Treasurer: T.J. McKenna; Hon. Sec: 
Sr. K. Cyr. Committees — Nurs. Educ: 
E. Moore; Nurs. Serv.: J.M. Dawes; Soc. 
& Econ. Welf: R. Mcfadyen; Finance: 
T.J. McKenna; Leg. & By-Laws: Norman 
Roberts; Pub. Rel.: H. Niskala; Exec Di- 
rector: F.A. Kennedy; Registrar: H. Grice; 
Director Communications serv.: C. Marcus. 

Manitoba 

Manitoba Association of Registered Nurses, 
647 Broadway Avenue, Winnipeg 1 . 
Pres.: M.E. Nugent; Past Pres.: D. Dick; 
Vice-Pres.: P. McNaught, Sr. T. Caston- 
guay. Committees — Nurs. Serv.: i. Robert- 
son; Nurs. Educ: S.J. Winkler; Soc. & Econ. 
Welf: S.J. Paine; Legis.: M.E. Wilson; Ac- 
crediting: M.E.Jackson; Board of Examiners: 
E. Cranna; Educ. Fund: M. Kullberg; Fi- 
nance: B. Cunnings; Pub. Rel. Officer: T.M. 
Miller; Registrar: M. Caldwell; Exec. Di- 
rector: B. Cunnings; Coordinator of Contin. 
Educ: H. Sundstrom. 

New Brunswick 

New Brunswick Association of Registered 
Nurses, 23 1 Saunders Street, Fredericton. 
Pres.: H. Hayes; Past Pres.: I Leckie; Vice- 
Pres.: A. Robichaud, L. Mills; Hon. Sec: 
M. MacLachlan. Committees — Soc. & Econ. 
Welf: B. Leblanc; Nurs. Educ: Sr. H. Ri- 
chard; Nurs. Serv.: Sr. M.L. Gaffney; Fi- 
nance: A. Robichaud; Legist.: M. MacLach- 
lan; Exec Sec: M.J. Anderson; Registrar: 
E.M. O'Connor; Adv. Com. to Schools 
of Nurs.: Sr. F. Darrah; Nurs. Assl. Comm.: 
A. Dunbar; Liaison Officer: N. Rideout; 
Employ. Rel. Officer: G. Rowsell. 

Newfoundland 

Association of Nurses of Newfoundland, 
67 LeMarchand Road, St. John's. 
Pres.: P. Barrett; Past Pres.: E. Summers; 
Pres. Elect.: E. Wilton; 1st Vice-Pres.: J. 
Nevitt; 2nd Vice- Pres.: E. Hill; Committees 
— Nurs. Educ: L. Caruk; Nurs. Serv.: A. 
Finn; Soc. & Econ. Welf: L. Nicholas; 
80 THE CANADIAN NURSE 



Exec Sec: P. Laracy; A.Kst. Exec. Sec: M. 
Cummings. 

Nova Scotia 

Registered Nurses' Association of Nova 
Scotia, 6035 Coburg Road, Halifax. 
Pres.: 1. Fox; Past Pres.: J. Church; Vice- 
Pres.: Sr. C. Marie, M. Bradley, E.J. Dob- 
son; Advisor, Nurs. Educ: Sr. C. Marie; 
Advisor, Nurs. Serv.: J. MacLean. Com- 
mittees — Nurs. Educ: Sr. J. Carr; Nurs. 
Serv.: G. Smith; Soc. & Econ. Welf: Roy 
Harding; Exec. Sec: F. Moss; Pub. Rel. Of- 
ficer: G. Shane; Employ. Rel. Officer: M. 
Bentley. 

Ontario 

Registered Nurses' Association of Ontario, 
33 Price Street, Toronto 289. 
Pres.: L.E. Butler; Pres. Elect: M J. Flaherty. 
Committees — Socio.-Econ. Welf: M.E.B. 
Purdy; Nursing: E. Valmaggia; Educator: 
A.E. GrifFm; Administrator: M.A. Liddle; 
Exec. Director: L. Barr; A.'^st. Exec: Di- 
rector: D. Gibney; Employ. Rel. Director: 
A.S. Gribben; Coord.. Formal Contin. Educ 
Program: L.C. Peszat; Director, Prof. Devel. 
Dept.: CM. Adams; Pub. Rel. Officer: I. 
LeBourdais; Regional Exec Sec: I.W. 
Lawson, M.I. Thomas, F. Winchester. 

Prince Edward Island 

Association of Nurses of Prince Edward 
Island, 188 Prince Street, Charlottetown. 
Pres.: C. Corbett; Past Pres.: B. Rowland; 
Vice-Pres.: B. Robinson; Pres. Elect.: E. 
MacLeod. Committees — Nurs. Educ: 
M. Newson; Nurs. Serv: S. Griffin; Pub; 
Rel.: C. Gordon; Finance: Sr. M. Cahill; 
Legis. & By-Laws: H.L. Bolger; Soc. & 
Econ. Welf: F. Reese; Exec. Sec- Registrar: 
H.L. Bolger. 

Quebec 

Association of Nurses of the Province of 
Quebec, 4200 Dorchester Boulevard, West, 
Montreal. 

Pres.: H.D. Taylor; Vice Pres.: (Eng.) S. 
O'Neill, R. Atto; (Fr.): R. Bureau, M. La- 
lande; Hon. Treas.: J. Cormier; Hon. Sec: 
R. Marron. Committees — Nurs. Educ: 
M. Callin, D. Lalancette; Nurs. Serv.: E. 
Strike, C. Gauthier; Labor Rel.: S. O'Neill, 
G. Hotte; School of Nurs.: M. Barrett. P. 
Proveni;al; Legis.: Sr. M. Bachand, M. Mas- 
ters; Sec-Registrar: N. Du Mouchel. 
Mouchel. 

Saskatchewan 

Saskatchewan Registered Nurses Association, 
2066 Retallack Street. Regina. 
Pres.: M. McKillop; Past Pres.: A, Gunn; 
l.<it Vice-Pres.: E. Linnell; 2nd Vice-Pres.: 
C. Boyko. Committees — Nurs. Educ: C. 
O'Shaughnessy; Nurs. Serv.: J. Belfry; Chap- 
ters & Pub. Rel.: M. Harman; Soc. & Econ. 
Welf: E. Fyffe; Exec. Sec: A. Mills; Reg- 
istrar: E. Dumas; Employ. Rel. Officer: A. 
M. Sutherland; Nurs. Consult.: E. Hartig; 
A.'ist. Registrar:!. Passmore. 



YY CANADIAN 

\^ NURSES- 



ASSOCIATION 



Board of Directors 

President E. Louise Miner 

President-Elect 

Marguerite E. Schumacher 

1st Vice- President 

Kathleen G. DeMarsh 

2nd Vice-President 

Huguette Labelle 

Representative Nursing Sisterhoods 

...Sister Cecile Gauthier 
Chairman of Committee on Social & 

Economic Welfare ..Marilyn Brewer 
Chairman of Committee on 

Nursing Service ...Irene M. Buchan 
Chairman of Committee on Nursing 
Education Alice J. Baumgart 



Provincial Presidents 

AARN M.G. Purcell 

RNABC M.D.G. Angus 

MARN M.E. Nugent 

NBARN H. Hayes 

ARNN P. Barrett 

RNANS J. Fox 

RNAO L.E. Butler 

ANPEI C. Corbett 

ANPQ H.D. Taylor 

SRNA M. McKillop 



National Office 

Executive 

Director Helen K. Mussallem 

Associate Executive 

Director Lillian E. Pettigrew 

General 

Manager Ernest Van Raalte 



Research and Advisory Services 

Nursing 
Coordinator Harriett J.T. Sloan 

Research Officer H. Rose Imai 

Library Margaret L. Parkin 

Information Services 

Public Relations Doris Crowe 

Editor. The Canadian 

Nurse Virginia A. Lindabury 

Editor. L'infirmiere 
canadienne Claire Bigue 



APRIL 197 « 



May 1971 



Vr^ 



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8 TESTED AND PROVEN TEXTS . . . 



FUNDAMENTALS OF NURSING: The Humanities and 

Sciences in Nursing 

By llinor Y. Fuerst, R.N., M.A., and LuVerne Wolff. UN., M.A. 

This extensively revised and expanded edition reflects greatly increased 
emphasis upon the independent functions Implicit in the nursing role. 
Klighlighted are nursing responsibilities that include care of man as a 
human being as well as a biological organism. Nursing measures, 
fundamental to the core of all patients, have been added and others 
updated. Stressed are the physiologic, pathologic and psychosocial 
bases for nursing intervention. 
446 Pages 166 Illustrations 4th Edition, 1969 $8.00 



BASIC PHYSIOLOGY AND ANATOMY 

By Ellen E. Chaffee, R.N., M.N., M. Litt. and Esther M. Greisheimer, 
Ph.D., M.D. 

This skillful blending of the two sciences provides the student with a 
VIVID picture of living man. Revised and updated to reflect recent 
research findings in bioscience, this edition has enhanced value as a 
basic text for students of nursing and allied health fields. Chapter-end 
summories and review questions combine to stimulate and guide the 
student. 

634 Pages 412 Illustrations, 45 in Color, plus Videograf® 

2nd Edition, 1969 $9.75 

BASIC MICROBIOLOGY 

Margaret F. Wheeler, R.N., A.B., A.M.; Wesley A. Yolk. Ph.D. 

A foundation text particularly designed for students in the health 
fields. The Second Edition has been entirely reset and features an 
attractive, highly readable format. All chopters have been updated 
in accordance with recent developments in the field, with many areas 
treated in greater depth. Special attention has been given to the 
spectacular advances in genetics, with emphasis on microbial genetics, 
cell structure, and immunology. DNA, RNA, and protein synthesis are 
presented so that the student can easily grasp the fundamental me- 
chanisms of synthesis and control of macromolecules. 
410 Pages 182 Illustrations Second Edition, 1969 $9.00 

Cooper's NUTRITION IN HEALTH AND DISEASE 

By Helen S. Mitchell, Ph.D., Sc.D., Hendeirka J. Rynbergen, M.S., 
Linnea Anderson, M.P.H., and Marjorie Y. Dibble, M.S. 

A comprehensive survey of the principles of nutrition and their ap- 
plication to normal and therapeutic needs is presented in the 15th 
Edition of this classic text. Additional emphasis is given to the under- 
lying biochemical and physiological components of nutrition as they 
affect the maintenance or restoration of optimum health. 
685 Pages 121 llustrotions 15th Edition, 1968 $9.50 



PHARMACOLOGY AND DRUG THERAPY IN NURSING 

By Morton J. Rodman, M.S., Ph.D., and Dorothy W. Smith, R.N., 
M.S., Ed.D. 

Thrs text's pharmacodynamic approach provides the student with a 

true understanding of the nature of drug action and a sound rationale 

for nursing intervention. Covers sources, dosage, physiologic action, 

untoward effects, contraindications and implications for nursing action. 

". . . the text. Pharmacology and Drug Therapy in Nursing, stands head 

and shoulders above all other pharmacology books written for nurses." 

— American Journal of Pharmaceutical Education 

"... a textbook of superb quality . . ." — from "Books of the Year," 

American Journal of Nursing 

738 Pages lllustroted 1968 $10.25 

TEXTBOOK OF MEDICAL-SURGICAL NURSING 

By Lillian S. Brunner, R.N., M.S.; Charles P. Emerson, Jr., M.D.; L. 
Kraeer Ferguson, M.D.; and Doris S. Suddarth, R.N., M.S.N. 

Massively revised and enlarged in scope, this edition is designed to 
develop the highest degree of expertise in the care of medical/surgical 
patients. Exceptional in its depth of pathophysiologic content, this text 
ahso emphasizes the psychosocial factors involved in patient care. 
New material is included on vascular/cardiac/respirotory intensive 
care nursing/neurologic and neurosurgical problems/burns/genitourinary 
and gynecologic disorder/rehabilitative measures. 
1031 Pages 387 Illustrations 2nd Edition, 1970 $14.95 

NURSING CARE OF CHILDREN 

By Florence G. Blake, R.N.. M.A.. F. Howell Wright. M.D., and 
Eugenia H. Waechter, R.N., Ph.D. 

Extensively revised and exponded, with numerous new illustrations, 
this superb text is without peer as a comprehensive, in-depth study 
of pediatric nursing. Recent findings in all areas of care are included 
— growth and development (from infancy to adolescence) medical 
entities; associated nursing therapies. Consideration is given to prob- 
lems of minority groups and cultural differences, the battered-child 
syndrome, and contemporory problems of the adolescent. 
588 Pages 254 Illustrations 8th Edition, 1970 $9.50 

BASIC PSYCHIATRIC CONCEPTS IN NURSING 

By Charles K. Hofling, M.D., Madeleine M. Leininger, R.N., Ph.D., 
and Elizabeth A. Bregg, R.N., B.S. 

By presenting basic concepts useful in all areas of nursing, the authors 
provide content and method essential to the practice of professional 
nursing in the nonpsychiatric as well as the psychiatric setting. 
Emphasis throughout rs on nursing care and the nurse's significant 
role, OS well as on problem solving, process recording and short and 
long-term nursing goals. 
583 Pages 2nd Edition, 1967 $7.25 



CONSIDER THESE OUTSTANDING 
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SERVING THE HEALTH PROFESSIONS IN CANADA SINCE 1897 



THE CANADIAN NURSE 



MAY 1971 



The 

Canadian 
Nurse 



^ 

^^7 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses' Association 



Volume 67, Number 5 



May 1971 



33 Report: CNA Annual Meeting 

37 Nurses in Prison G- Norens 

40 The Research Process L.E. Heidgerken 

44 Problems, Issues, Challenges 

of Nursing Research F.G. Abdellah 

47 A Community Clinic Where People Count L.E. Lockeberg 

5 1 Young Diabetics Enjoy Camp, Too D. Fitzgerald 

54 The Subcutaneous Injection M. Pitel 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 



4 Letters 

24 New Products 

29 Dates 

58 Books 



7 News 

26 Names 

30 In a Capsule 

60 Accession List 



Executive Director: Helen K. Mussallem • 
Editor: Virginia A. Lindabury • Assistant 
Editor: Liv-Ellen Lockeberg • Editorial As- 
sistant: Carol A. Kollarsky • Production 
Assistant: ElizatKth A. Stanlon • Circula- 
tion Manager: Berjl Darling • Advertising 
Manager: 'Ruth H. Baumel • Subscrip- 
tion Rates: Canada: one year, $4.50; two 
years, $8.00. Foreign: one year, $5.00; two 
years, $9.00. Single copies: 50 cents each. 
Make cheques or money orders payable to the 
Canadian Nurses' Association. • Change of 
Address: Six weeks' notice; the old address as 
well as the new are necessary, together with 
registration number in a provincial nurses' 
association, where applicable. Not responsible 
for journals lost in mail due to errors in 
address. 



.Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in india ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles 
sent, nor to indicate definite dates of 
publication. 

Postage^ paid in cash at third class rale 
MONTREAL, P.O. Permit No. 10,001. 
50 The Driveway, Ottawa, Ontario. K2P 1E2 
O Canadian Nurses' Association 1971. 



Editorial 



MAY 1971 



A few months ago, the Canadian Psy- 
chiatric Association took a stand againsi 
the Soviet Union's practice of commit 
ting to mental hospitals sane person: 
who disagree with aspects of Sovie 
society. (News, page 12.) 

Some will say that this stand, taker 
by a relatively small association ( !,80C 
members), will have little effect ir 
persuading the USSR to cease thi; 
inhumane practice. Others will say it ii 
not the purpose of a professional organ 
ization to become involved in the inter 
nal affairs of another country. 

We say this is a courageous stanc 
taken by a dynamic organization thai 
has raised its sights above the pedantic 
trivialities that sometimes beset pro 
fessional associations. We believe it i) 
the kind of stand that more association; 
should take. Can any health professior 
in Canada afford to sit back compla 
cently and discuss 'the delivery of hcaltl 
care" in our own country and ignore 
what is going on in the world? 

We are not implying that healtf 
professions in Canada, including the 
Canadian Nurses" Association, shoulc 
cease to strive for the best possible 
health services for the country's citi 
zens. What we are suggesting is tha 
we must go beyond this. 

Perhaps we will even have to gc 
beyond what our own governments an 
saying — or not saying. For example 
what government in the Western democ 
racies has taken a stand against the 
war in Vietnam? What governmcn 
has condemned the slaughter of th< 
citizens of Vietnam, as evidenced b) 
the Mylai atrocity? 

Politics, you say? Another country '< 
affairs that in no way concern the healtl 
professions? We wonder. 

We only know that as we write thii 
editorial today, Easter Sunday, we 
cannot ignore what is happening arounc 
us. We cannot, in all conscience, avoic 
raising these questions of involvemem 
on a global basis. As Robert Jay Liftor 
wrote in an article entitled "Beyonc 
Atrocity" {Saturday Review, March 27 
1 97 1 ), "The task ... is to confroni 
atrocity in order to move beyond it.' 

— V.A.L 
THE CANADIAN NURSE 3 



letters 



Letters to the editor are welcome. 

Only signed letters will be considered for publication, but 

name will be withheld at the writer's request. 



Quebec's Bill 64 

The writer of this letter was quoted by 
The Canadian Nurse (News, March 
197] , pp. 10 and 12) in an item con- 
cerning Quebec's Bill 64. Here are her 
comments. 

In February, I was asked by the jour- 
nals, in a telephone interview, to give 
my personal opinion on Bill 64. I wish 
to point out that no "loophole in the 
law" was mentioned by me and that I 
did not speak on behalf of the Associa- 
tion of Nurses of the Province of Que- 
bec as indicated on page 12 of the 
March 1971 issue. — Cecile Gauvin, 
R.N., Assistant Registrar, ANPQ. 

Concerned about Bill 64 

As an English-speaking immigrant to 
Canada, I was most distressed to read 
the news item, "Migrant Nurses to At- 
tend French-Language Classes," (News 
March 1971). 

I assume from the item that if I should 
move to Quebec, then 1 would have to 
prove a working knowledge of French 
before I could join the professional 
nursing association and gain employ- 
ment as a registered nurse in that prov- 
ince. It appears that English-speaking 
Canadian nurses do not have to prove a 
working knowledge of French, nor do 
French-speaking Canadian nurses have 
to prove a working knowledge of Eng- 
lish to join this same professional nurs- 
ing organization and to gain employ- 
ment as a registered nurse in this same 
province. 

Is this not outright discrimination 
against the immigrant — requiring 
her to meet standards that any other 
Canadian nurse does not have to meet? 

This is a law that makes some nurses 
second-class members of the Quebec 
nurses' organization. What is the Cana- 
dian Nurses' Association doing to bring 
about the removal of Bill 64 and to 
prevent further such legislation? — 
Barbara Kisilevsky, R.N., M.N., Kings- 
ton, Ontario. 

Listening to the layman 

Thank you for your March editorial 
about nurses" attitudes toward relatives 
and friends of patients. I was particu- 
larly struck by your question, "... do 
we brush aside their concerns, believ- 
ing we are dealing with troublesome 
visitors who are trying to interfere with 
the care we believe is best?" How often 
4 THE CANADIAN NURSE 



we do just that! I particularly remember 
my three years in an intensive care 
unit: the heavy work load, the extreme 
concern and fear of relatives, and the 
tension caused by combining these two 
factors. We seldom had time to talk to 
visitors, much less listen to them. 

When I left ICU nursing for the field 
of chronic hemodialysis, I found myself 
in an entirely different situation. We 
come to know our patients extremely 
well, since they spend two or three days 
a week under our care. Occasionally 
a close relative calls us to describe some 
problem or symptom a patient has 
complained of at home, but has not 
mentioned to us. These comments are 
invaluable in planning the long-term 
care and rehabilitation of our patients. 

It is sometimes difficult for a skilled 
professional person to admit a layman 
can offer useful and helpful advice. But 
perhaps the greatest virtue a profession- 
al nurse can possess is humility — a 
genuine awareness of how little she 
really knows about life and a constant 
willingness to learn from any and every 
available source. Such willingness cer- 
tainly includes a sincere interest in her 
patients' relatives and in their concerns, 
suggestions, and observations. This is 
an integral part of the art and science of 
professional nursing! ' — Christine Frye 
Reg. N., Ottawa. 



Abortion and the Criminal Code 

In reference to the stand taken by the 
Canadian Psychiatric Association, I 
was surprised to read that "all nurses 
who were interviewed agreed abortion 
should be removed from the Criminal 
Code" (News, Feb. 1971). 

I have been a nurse for over 30 years 
and have intellectualized about abor- 
tions in my day. I have seen tragedies, 
such as the death of four-year-old 
Ewan's mother who died of septicemia 
after a self-procured abortion. 

I have also read the statistics and 
heard the arguments pro and con. These 
arguments are not new, but they are 
more vociferous and better written 
than ever. The grammar is good, the 
style is polished, the logic seems irrefut- 
able. Is it any wonder that young people 
are bewildered? Instead of arguments, 
I would like to offer an anecdote from 
my own experience. 

Recently I had a patient, a young 
married woman, who had had a dila- 



tion and curettage following an inevit- 
able abortion. When I went into her 
room to tell her she could go home 
and offered to phone her husband for 
her, I found her sobbing. As I was a 
bit out of touch with this branch of 
nursing, having done more medical and 
orthopedic work in recent years, I told 
the head nurse that the patient seemed 
acutely depressed. The head nurse 
said, "Oh, that's O.K. She'll get over 
that faster at home. Dr. C. (the gyne- 
cologist) says this is routine following 
a D. & C. 

Young nurses have chosen a noble 
(excuse the old-fashioned word) profes- 
sion because they are normal, healthy 
young women and nursing is something 
women traditionally have done well. 
These girls also have the same dreams 
and aspirations my colleagues and I 
had 30 years ago. They want love and 
motherhood, not empty arms and an 
aching heart. But they are bombarded 
with articles like "Motherhood' — 
Who Needs It?" in a popular family 
magazine, and films like "Mash" in 
which the men they most admire (young 
doctors, who else?) perform scientific 
miracles in the operating room and 
behave like gangsters outside of it. 

Let us think twice before removing 
abortion from the Criminal Code. How- 
ever, let us make sure our magistrates 
who enforce the laws are ethical men 
and also men who believe the law must 
be enforced non-punitively. — Mrs. 
Kay Eliason, R.N., Winnipeg, Man. 



Head nurse problem 

I wonder whether a survey has ever 
been made of a nursing problem I am 
sure is Canada-wide. The problem 
that concerns me is the change that 
takes place when nurses — pleasant 
nurses — become head nurses and 
almost overnight become officious 
tyrants. 

Conscientious staff members, some 
of whom may have worked in this place 
for years, suddenly cannot do anything 
right. These head nurses seem to stop 
liking their staff. Why? 

Yet other head nurses, who are just 
as efficient, maintain a good rapport 
with their staff. The patient reaps the 
benefits of this rapport. 

Could someone write an article on 
how to be a good head nurse? — R.N., 
Steinbach, Manitoba. ■§■ 

MAY 1971 





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news 



CNA Board Issues Statement 
On Family Planning 

Ottawa — Canadian nurses must ac- 
cept more responsibility for promoting 
family planning programs across the 
country. This belief was expressed by 
the Canadian Nurses' Association's 
board of directors on April 1 , the last 
day of its meeting at CNA House. The 
statement on family planning, as ap- 
proved by the board, reads: 

"The CNA believes that promotion 
of health is one of the primary res- 
ponsibilities of the nurses of this coun- 
try. Family planning, with its supportive 
educational programmes, is one of the 
methods that can be used to maintain 
health and to contribute to the quality 
of living of our citizens. Current scien- 
tific knowledge and an increasing 
understanding of the whole process of 
life makes this planning feasible. 

"Canadian nurses must accept the 
responsibility for preparing themselves 
to participate intelligently in such 
activities. The responsibility for iden- 
tifying the need and the urgency for ac- 
tion with a variety of approaches is 
one which nurses should not evade. As 
citizens, we must urge the establishment 
of family planning programmes across 
the country." 

The CNA board also endorsed, in 
principle, a statement on abortion. This 
statement will be sent to the provincial 
nurses' associations for their reactions 
and endorsement by June 20, 1971. 
If endorsed by a majority of the pro- 
vincial nurses associations, the state- 
ment will then become the official stand 
of the CNA. 

CNA Ad Hoc Committee Gets 
Good Response From Publishers 

Ottawa — The program of action by 
the ad hoc committee on French-lan- 
guage textbooks was outlined by com- 
mittee chairman Huguette Labelle, at 
both the Canadian Nurses' Association 
annual meeting on March 31 and the 
board of directors meeting on April 1 . 

The committee's intention is to pro- 
mote the production in French of text- 
books on nursing care. Also, the com- 
mittee plans to encourage the trans- 
lation or adaptation of excellent basic 
nursing care textbooks which could be 
helpful to nurses if they were available 
in the French language. 

Letters have been sent by the com- 
mittee to publishers of English-lan- 
MAY 1971 




Sherry, a birthday cake, presents, and two special guests helped the Canadian 
Nurses' Association celebrate a special anniversary April 1 : Five years ago to 
the day CNA moved into its new headquarters at 50 The Driveway. The CNA 
board of directors took time out from its three-day meeting to remember the 
occasion, and invited Evelyn A. Pepper, who was vice-chairman of the commit- 
tee that pioneered the creation of CNA House, and Dorothy Percy, the build- 
ing's first visitor, to participate in the short ceremony. Left to right, M. Schuma- 
cher, CNA president elect; E.L. Miner, president; Miss Pepper and Miss Percy; 
Dr. H.K. Mussallem, executive director of the Canadian Nurses' Association. 



guage nursing textbooks, outlining the 
need for textbooks to be published in 
French. The publishers have responded 
enthusiastically. Two publishers are 
working jointly on the translation and 
publication of Fundamentals of Patient 
Care: A Comprehensive Approach to 
Nursing by B. Kozier and B. Du Gas. 
Six other texts have been translated into 
French and are scheduled for publica- 
tion. 

Mrs. Labelle said it is possible the 
committee will eventually act as liaison 
between CNA and publishing firms. 

The committee is also interested that 
audiovisual aids be available in French. 
It intends to compile a listing of French- 
language films and tapes to provide 
a basic source for use in teaching by 
French-speaking nurse educators. 

CNA Board Votes In Favor 

Of Commonwealth Association 

Ottawa — The Canadian Nurses' Asso- 
ciation is in favor of the establishment 
of a Commonwealth Nurses' Federa- 



tion and will indicate its wish to become 
a Founder member. This decision was 
made by the CNA board of directors 
at its meeting March 29, 30, and April 
1, 1971. 

The idea of establishing this Feder- 
ation originated in June 1969, when 
representatives of 33 Commonwealth 
countries met in Montreal during the 
Congress of the International Council 
of Nurses to decide if such an associa- 
tion was needed. An ad hoc committee 
was then set up to take the necessary 
action to establish a Commonwealth 
organization for nurses. Dr. Helen 
K. Mussallem, executive director of 
the CNA, is one of the seven members 
of this ad hoc committee and represents 
the Atlantic region. 

A number of Commonwealth profes- 
sional ass(x:iations are already in ex- 
istence and receive financial assistance 
from the Commonwealth Foundation. 
A basic aim of the Foundation is to 
promote the growth of Commonwealth 
associations, and it has shown interest 
THE CAt^DIAN NURSE 7 



in the work being done to establish a 
nurses' association. 

The decision to establish a Common- 
wealth Nurses' Federation will be made 
July 1, 1971, when the ad hoc com- 
mittee, chaired by Catherine M. Hall of 
the United Kingdom, will meet in Eng- 
land. By then all nurses' associations 
in the Commonwealth will have maicat- 
ed whether or not their associations 
would support the setting up of this 
Federation. 

Board Grants DBS 
Access To Address Tapes 

Ottawa — At its April 1 meeting, the 
Canadian Nurses' Association board 
of directors agreed to a request from 
the Dominion Bureau of Statistics for 
access to the address listings of The 
Canadian Nurse and L'infirmiere cana- 
dienne. The health and welfare division 
of DBS is undertaking a series of studies 
aimed at special groups of nurses, thus 
it is necessary that the Bureau undertake 
direct mail surveys to these groups. 

Since 1970, registration torms re- 
ceived from the provincial nurse reg- 
istrars have been edited by CNA staff 
and passed to DBS for processing. 
The Bureau has keypunched, edited, 
and tabulated data by computer to 
produce statistics by provinces and 
these data will be published in DBS 
publications for public information. 

In making the request, F. Harris, 
director, health and welfare division, 
DBS, said, "The importance of ade- 
quate accurate statistics on Canada's 
health manpower resources cannot be 
overemphasized tor both long- an<; 
short-range planning. Data are required 
on the basic counts of training pro- 
fessionals working both in and out of 
the health field. 

"The work of your association in 
developing model national registration 
data has been most important, and the 
system we are proposing is based upon 
your association's work over the past 
few years." 

Mr. Harris continued by discussing 
the special studies, "We can see the 
necessity of cohort studies on the ca- 
reers of nurses who have received dif- 
ferent types of basic training. We also 
see surveys aimed at finding out what 
would be required to bring people back 
into the health field including those 
who are not employed or those employ- 
ed in some occupation outside the health 
field." 

The CNA board authorized the ex- 
ecutive director or her designate to 
8 THE CANADIAN NURSE 




Dr. Helen G. McArthur receives a gold bracelet from E. Louise Mmer on behalf 
of the Canadian Nurses' Association. 



provide the address tapes to DBS for 
suitable projects. 1 hese will be provided 
at no cost to the Bureau. 

At the Doard meetmg, Dr. Helen K. 
Mussallem, CNA executive director, 
explained that provincial associations 
have access to the statistical compila- 
tions of DBS and that they need only 
make a request for the information to 
be supplied. 

Helen McArthur Chalks Up A first 

Ottawa — Dr. Helen G. McArthur is 
the first nurse to receive an Honorary 
Citation from the Canadian Nurses' 
Association. The ceremony took place 
at the CNA annual meeting held on 
March 3 1 at the Chateau Laurier Hotel. 

In presenting the emblematic cita- 
tion to Dr. McArthur, Margaret M. 
Hunter, chief nursing officer for St. 
John Ambulance in Canada, outlined 
briefly the career of the national direc- 
tor of nursing service of the Canadian 
Red Cross Society, a position from 
which Dr. McArthur is retiring in a 
few months. 

Helen McArthur was among the 
pioneers in public health nursing in rur- 
al Alberta shortly after obtaining her 
bachelor of science degree from the 
University of Alberta school of nurs- 
ing. Later, she became acting director 
of the same school, having obtained her 



master's degree in supervision and 
teaching from Columbia University. In 
1944 she rejoined the Alberta depart- 
ment of public health as superintendent 
of the public health nursing branch. 

In 1946, Dr. McArthur joined the 
Canadian Red Cross Society. In 1954, 
at the personal request of Syngman 
Rhee and under the auspices of the 
League of the Red Cross Societies, she 
began an 1 8-month assignment in Korea 
and Japan. In Soeul, the nurses' resi- 
dence of the Red Cross Hospital has 
been named "McArthur Hall" as a 
tribute to her services there. 

Dr. McArthur, always active in nurs- 
ing organizations, was elected pres- 
ident of the Canadian Nurses' Associa- 
tion in 1951 and served for two terms 
in that position. She has served as presi- 
dent of the University of Alberta Hospi- 
tal Alumnae Association, first vice- 
president of the Alberta Association of 
Registered Nurses, and chairman of 
the nursing section of the Canadian 
Public Health Association. 

In 1957, Dr. McArthur received the 
highest international nursing award, 
the Florence Nightingale Medal, from 
the International Committee of the 
Red Cross. In 1958, she received the 
Coronation Medal, and in 1964, an 
honorary degree of~Doctor of Laws 
(Continued on page 10) 
MAY 1971 




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355 BURLINGTON RD., RIVERSIDE, ILL. 60546 



10 THE CANADIAN NURSE 



(Continued from page 8) 

trom her alma mater, the University 
of Alberta. 

E. Louise Miner, president of CNA 
gave Dr. McArthur a gold bracelet as 
a memento of her contribution to nurs- 
ing in Canada and abroad. 

In thanking the association, and hint- 
mg at yet another career, Dr. McAr- 
thur's remarks "... and when I'm 
tired of oatmeal porridge and want a 
filet mignon, I shall go out and nurse 
the aged, for they need the kind of nurs- 
ing I can give them ..." gave way to a 
standing ovation from the general meet- 
ing. 

Miss Miner's concluding comment, 
"She "is a person whose country is the 
world and whose religion is to do 
good," was a capsule portrait of the 
nurse who was given yet another honoi 
that was her due. 

Survey To Determine Demand 
For Tape Cassette Program 

Ottawa — At its March meetmg, the 
board of directors of the Canadian 
Nurses' Association agreed to conduct 
a bilingual survey of nurse educators 
and administrators to determine their 
interest in a tape cassette program that 
now offers doctors medical education 
and information through audio tapes. 

Dr. A. Peart, former general sec- 
retary of the Canadian Medical Asso- 
ciation, ana now medical director of 
Medifacts Ltd., a company formed to 
set up and administer this service for 
general practitioners, told the board his 
company could also provide CNA with 
:he technical expertise to start its own 
program. As well, Medifacts would pay 
half the cost of the survey, he said. The 
survey will cost CNA $600. 

This new Canadian cassette program, 
which began for doctors March 29, 
1971, could similarly be used by CNA 
to provide nurses with new knowledge 
in capsule form and association news. 
Or. Peart explained. Although the tapes 
could be any length, he suggested 30- or 
60-minute tapes consisting of short six- 
minute items and three to five minutes 
of news. 

Based on 1,000 subscribers, the 
cost of one cassette would be $5, though 
advertising could considerably reduce 
the cost. Dr. Peart said the cassettes 
for the 5,000 general practitioner sub- 
scribers, which contain six one-minute 
advertising slots, cost only $1 each. 
These doctors receive a cassette every 
two weeks, but are only billed twice 
yearly, according to Dr. Peart. 



Dr. Peart noted that a medical ad- 
visory committee selects topics of in- 
terest to GPs, sets out the objective? 
ot the program, and commissions each 
presentation from a prominent Can- 
adian doctor. These doctors are paid for 
their contributions he added. There is 
also a committee that screens advertis- 
ing for "good taste." 

When an advertisement for a drug 
is on a tape, a full account of the drug 
is included with the cassette. Illustra- 
tions may be included with some cas- 
settes. Another extra teature that some- 
times accompany the tapes are 35-mm 
slides. 

Medifacts also offers its subscribers 
cassette players for $35 — $15 less 
than the retail price. Dr. Peart said. 
Accessories, such as a foot pedal and 
telephone hookup, are available, too. 

"We may eventually provide this 
service in all medical sciences." Ur. 
Peart told the CNA board. He also said 
Medifacts is trying to set up a French- 
speaking program. 

Quebec's Language Legislation 
Explained By ANPQ 

Montreal, Quebec — The Association 
of Nurses of the Province of Quebec 
has issued an explanation of the provi- 
sions of the Professional Matriculation 
Act as it applies to professionals im- 
migrating to Quebec. (News, March 
1971, p. 10) 

The ANPQ is one of 19 corporations 
covered under the act, which stipulates 
that the association "cannot admit any 
person who is not a Canadian citizen 
to the study or to the practice of the 
protession it such person does not 
have a working knowledge of the French 
language determined in accordance 
with the standards established by regu- 
lation of the Lieutenant-Governor in 
Council." 

The ANPQ received regulations as 
stipulated by an order-in-council (num- 
ber 936) on March 10, 1971. The 
regulations defined the meaning of 
"immigrant" as "any person who is not 
a Canadian citizen but is legally admit- 
ted to Canada to remain there perma- 
nently and is domiciled in Quebec." 

The association is studying the arti- 
cles covered in the legislation, which 
might eventually affect the nursing 
staff of English-speaking hospitals iii 
the province. The ANPQ is in contact 
with different levels of the departments 
of social affairs and immigration to 
help solve problems in the application 
of the new law. 

*»ome ''ifcerpts from the law are: 
the candidates, that is. the immi- 
grants working knowledge of French 
is determined by evaluating ability 
to understand written texts, phonetic 
(Continued on page 12 1 

MAY 1971 



the shape of change: 



dlscworii 



New 8th Edition! Anthony 

TEXTBOOK OF ANATOMY 
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Instructor of Anatomy and Pfiysioiogy, Frances Payne Bolton 
School of Nursing, Case Western Reserve University, Cleveland, O.; 
with the collaboration of NORMA JANE KOLTHOFF, R.N., B.S., 
Ph.D., Professor of Nursing, Frances Payne Bolton School of 
Nursing. April, 1971. 8th edition, 580 pages plus FM l-XII, 8" x 
10", 320 illustrations (119 in color), including 222 by Ernest W. 
Beck and a Trans- Vision * insert on human anatomy. About S 10.25. 



New 8tti Edition! Anthony 

ANATOMY AND PHYSIOLOGY 
LABORATORY MANUAL 

Encourage your students to discover the fundamentals 
of anatomy and physiology for themselves! The most 
popular manual of its kind, this practical, uncomplicated 
workbook offers problems to solve, rather than directions 
merely to follow. This deductive approach can help your 
students gain a better understanding of the scientific 
method; it can also help you save time in setting up and 
supervising your laboratory periods. 

These carefully planned experiments require little 
preparation time, and simple, inexpensive equipment. More 
than half of the 76 helpful drawings are labeled, to guide 



collection of the specific data needed to answer questions 
at the end of each procedure. The streamlined method of 
writing up conclusions saves you time in checking students' 
work with the complimentary answer booklet. More exer- 
cises in this edition give you an even greater flexibility in 
selecting the ones which meet your teaching objectives. Pi// 
this efficient guide to work in your laboratory next 
semester! 



By CATHERINE PARKER ANTHONY, R.N., B.A., M.S. April, 
1971. 8th edition, approx. 232 pages, 8" x 10", 76 drawings, 49 to 
be labeled; perforated and punched. Price, SB. 20. 



MOSSY 



TIMES MIRROR 

THE C.V MOSBY COMPANY, LTD • 86 NORTHLINE ROAD • TORONTO 374. ONTARIO. CANADA 



MAY 1971 



THE CAI^ADIAN NURSE 11 




I C out i maul from p<if!i' 10) 

perception, ability to understand spoken 
French, oral expression. A series of 
standardized and normalized tests are 
used for the evaluation. 

Another article states that every 
candidate must submit an application 
to the department of immigration of 
Quebec. A candidate may be exemp- 
ted from the examination if he demon- 
strates to the examining committee that 
his mastery of the French language is 
obvious. 

The examining committee studies 
candidates' records. It keeps an up-to- 
date register in which the name of 
each candidate and his results are 
recorded. Examination sessions are 
held once a month in the Montreal and 
Quebec City offices of the department, 
and at any other time and place deemed 
necessary by the department. 

Candidates who pass the examina- 
tion are awarded a certificate by the 
department. A copy is sent to the can- 
didate's professional corporation. A 
candidate who tails may try the exami- 
nation again after a three-month period. 

Canadian Psychiatrists 
Protest Soviet Misuse 
Of Mental Hospitals 

Toronto, Ont. — The Canadian Psychi- 
atric Association has appealed to world 
medical bodies and doctors to join 
them in their protest of the Soviet 
Union's use of mental institutions for 
incarcerating sane people who disagree 
with aspects of Soviet society. CPA is 
the first medical organization m the 
world to protest this practice publicly. 

In an article in the Toronto Telegram 
February 17, Peter Worthington, who 
has worked in Moscow as Telegram 
correspondent, said the Canadian psy- 
chiatrists have urged that the World 
Health Organization Canadian Medical 
Association, the World Psychiatric 
Association, and other international 
bodies look at ways of taking action 
against the Soviet use of mental institu- 
tions as prisons for dissenters. 

Credit for providing the impetus for 
the CPA stand is given to the executive 
body of the psychiatric section of the 
British Columbia Medical Association. 
Dr. Norman Hirt, chairman of the B.C. 
psychiatry section, compares the Soviet 
practice with the Nazi practice of ex- 
perimental surgery and killing the 
"socially undesirable." 

Dr. Hirt writes: "Death and dying 
take many forms. The Nazis killed 
corporeally after torture; the Russians 
12 THE CANAUIAN NURSE 



are killing the delicate and individual- 
istic mind-structures of their 'mental' 
prisoners. This crime is no less evil than 
actual death." 

According to the Telegram story. 
Dr. Hirt is particularly upset because 
up to now no world medical body has 
reacted directly against the Soviet 
"mind-death camps." He notes in a 
CPA report that world medical opinion 
was also silent when the Nazis began 
their medical obscenities in the 1930's. 

The report compares Nazi and Soviet 
atrocities: "In Germany, the advance 
of killings went from the mentally 
retarded, the 'chronic' schizophrenic, 
the 'criminally insane,' to the 'racially 
impure' — Jews, Poles, and Russians. 

"With the convenience of cynical 
diagnostic categories it is now easy 
for the Russians to move from "schizo- 
hetero-thinkers' (political dissenters) to 
'schizo-religious-deviates' — namely 
orthodox religious believers, particu- 
larly Jews of Russia who are being 
politically persecuted today." 

The report also points out: "Once 
you can kill or torture or destroy men- 
tally one human being and find that you 
are not punished or isolated, then the 
sphere of behavior . . . becomes enlarg- 
ed. There is no doubt that we are seeing 
in Russia the actual beginnings of a 
future holocaust. . . . 

"As we know from actual data, some 
of these people so committed to men- 
tal hospitals have been tortured to 
death by the advanced medical tech- 
nology available to psychiatry today, 
including drugs, electrical shock and 
various kings of physical coercion." 

Dr. Aldwyn Stokes, CPA president, 
said the report has been sent to the 
Canadian Medical Association, which 
is expected to endorse the report and 
forward it to the United States and the 
World Health Organization. And ac- 
cording to the Telegram. Dr. Stokes 
emphasizes that the gesture is "com- 
pletely non-political" and based only 
on facts. 

Research Officer Attends 
ANA National Conference 

Ottawa — The Canadian Nurses' Asso- 
ciation research officer. Rose Imai, 
was one of nearly 100 nurse research- 
ers invited to attend the seventh nursing 
research conference sponsored by the 
American Nurses' Association in Atlan- 
ta, Georgia, from March 10 to 12. 

The conference, funded by a grant 
from the division of nursing, bureau of 
health manpower education, provided 
a forum where nurse researchers could 
engage in the critical analysis of select- 
ed research studies. The program focus- 
ed on the research methods and mea- 
surement tools applicable to the study 
of nursing problems; problem-areas 
encountered in research; and implica- 



tions of the findings for nursing practice 
and for further research. 

The conference was part of the con- 
tinuing efforts of ANA and the division 
of nursing to assist in the further devel- 
opment of methodological and com- 
municative skills of nurse researchers. 

Miss Imai found the conference 
both "stimulating and exciting." The 
conference focused on critiques of 
papers given to the delegates in ad- 
vance. "This method was extremely 
valuable because it provided a good 
basis for discussion," she said. 



Committee On Clinical Training 
For Nurses In The North 
Reports To Health Minister 

Ottawa — If the recommendations 
made in a report submitted last Oc- 
tober to the federal minister of health, 
John Munro, are implemented, nurses 
employed in northern nursing stations 
by the medical services branch of the 
department of national health and wel- 
fare will be given a formal training 
program lasting a maximum of six 
months. 

This program would begin with a 
two- or three-month apprenticeship 
in a northern nursing station, possibly 
combined with a departmental orienta- 
tion program, to orient the nurse to 
life in a northern nursing station and 
help her identify her learning needs. 

The report followed visits to areas in 
northern Quebec and Manitoba and the 
Northwest Territories by the eight 
members of the Committee on Clinical 
Training of Nurses for Medical Services 
in the North. Chairman of the commit- 
tee was Dr. Dorothy J. Kergin, director 
of McMcMaster University s school of 
nursing. 

In the nursing stations, committee 
members found there was a disparity in 
educational and experiential back- 
grounds among nurses. The committee 
notes in its report that because of such 
factors as isolation, most nurses see 
their work lasting approximately two 
years until transfer, promotion, or 
resignation. 

In the committee's view, the overall 
objective of a training program for 
nurses employed by, or seeking em- 
ployment with, the medical services 
branch in the North is to increase the 
skills of the nurse in physical assess- 
ment and case management. It recom- 
mends that primary emphasis in all 
areas be on distinguishing between 
normal and abnormal findings, des- 
cription of signs and symptoms, and 
on management of simple problems. 

On completion of the program, the 
report says, the nurse should possess 
skills in interviewing, history taking, 
and carrying out a basic physical exam- 

(Coiilimu'il on page 14) 
MAY 1971 



the shape of change: 



Involvenem 



New 5th Edition! Shafer et al 

MEDICAL-SURGICAL 
NURSING 

This was the first text to combine two basic areas of 
clinical nursing in one patient-oriented volume, and it 
remains the foremost book in the field! Reflecting your 
students' unchanging involvement in a rapidly changing 
profession, this modern new edition retains the essential 
focus on individualized nursing care, while presenting 
recent advances in procedures and treatment. The new 
author's thoughtful presentation stresses that rapid changes 
in treatment demand alert, flexible nursing care based on 
complete understanding of the rationale for treatment of a 
given patient. In keeping with this approach, expanded and 
reorganized material pinpoints important new develop- 
ments in medical therapy and nursing care. 

A rewritten and enlarged chapter examines nutrition 
as a dynamic factor in nursing care. Extensively revised 
chapters reflect progress in many other important areas. 
Scientifically accurate discussions update information on 
cancer chemotherapy, diagnostic procedures in cardiovas- 
cular disease, endotracheal intubation and tracheostomy 
care, and many other clinically relevant topics. The chapter 
on patients with personality disorders notes the intimate 
relationship of organic and functional conditions, and 
presents facts on recently developed drugs which control 
behavior. In addition, this chapter examines conditions 
related to alcoholism, drug abuse, and narcotic addiction. 
This timely material outlines symptoms of commonly 
abused drugs, and current treatment. 

Redesigned in a modern format, with larger pages, this 
attractive presentation also features more than 75 new 
drawings and photographs. A helpful Teacher's Guide is 
furnished without charge to instructors adopting this book. 
The effective combination of text, workbook and case 
studies is the most complete approach to medical-surgical 
nursing you could adopt for your classes! 

By WILMA H. PHIPPS, R.N., A.M., Associate Professor and 
Chairman of Medical-Surgical Nursing, Frances Payne Bolton School 
of Nursing, Case Western Reserve University, Cleveland, O.; with the 
collaboration of Kathleen Newton Shafer, R.N., M.A.; Janet R. 
Sawyer, R.N., Ph.D.; Audrey M. McCluskey, R.N., M.A., Sc.M.Hyg.; 
and Edna Lifgren Beck, R.N., M.A. June, 1971. 8th edition, approx. 
800 pages, 8" x 10", 414 illustrations. About $13.15. 



A New Book! Shafer et al 

PATIENT CARE STUDIES 
IN MEDICAL- 
SURGICAL NURSING 

Realistic patient care problems show your students 
how to establish sound nursing objectives. Valuable rein- 
forcement for their clinical experience, these carefully 
organized studies are correlated with the new 5th edition of 
Medical-Surgical Nursing (described at left). 

Each perceptive discussion follows a logical five-part 
format. Beginning with a statement of the patient's medical 
history, the authors then explain his relevant social back- 
ground, delineate laboratory findings, and describe current 
medical or surgical treatment for his condition. The final 
section then demonstrates how the nurse can draw on all 
this information to formulate sound nursing plans which 
consider the patient as an individual as well as his disease. 
Consider this new book s value in your teaching program! 

By WILMA H. PHIPPS, R.N., A.M.; and ROSEMARY RICH, R.N., 
Ph.D., Associate Professor, Frances Payne Bolton School of Nursing, 
Case Western Reserve University, Cleveland, O. September, 1971. 
Approx. 150 pages, 7" x 10", illustrated. 



New 2nd Edition! Joel et al 

WORKBOOK AND STUDY 
GUIDE FOR MEDICAL- 
SURGICAL NURSING 
A Patient-Centered Approach 

This stimulating workbook vividly demonstrates appli- 
cation of the principles of medical-surgical nursing care. Its 
23 patient-centered case studies encourage development of 
problem-solving techniques, and at the same time review 
basic scientific knowledge and nursing skills. A Teacher's 
Guide is provided without charge to instructors adopting 
this flexible book. 

By Alma L. Joel, R.N., B.S.N. : Marjorie Beyers, R.N., B.S., M.S.; 
Lois S. Carter, R.N., B.S.N. ; Barbara Puras, R.N., B.S.N. ; Mary Ann 
Pugh Randolph, R.N., B.S.N. ; and Dorothy Savich, R.N., B.S. 1969, 
2nd edition, 319 pages plus FM l-X, TA" x lO'/i". 13 illustrations. 
Price, S5.25. 



MAY 1971 



MOSBY 

TIMES MIRROR 

THE C.V. MOSBY COMPANY. LTD. • 86 NORTHLINE ROAD • TORONTO 374, ONTARIO, CANADA 

THE CANADIAN NURSE 13 



Just as you 

can't call any 

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Niagara 




you can't call 

any Conform 

Bandage a 

KLING* 

BANDAGE. 

There's really only one KLING 
Conform Bandage — by Johnson 
& Johnson. 

KLING is the unique, soft, all ab- 
sorbent cotton bandage that is 
more than equal to the bandaging 
requirements of areas that are hard 
to bandage and hard to keep ban- 
daged. 

Because KLING is self-adhering, it 
clings to itself, conforming to un- 
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stretch over 40%, so not to con- 
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KLING Conform Bandages — 5 
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14 THE CANADIAN NURSE 



news 



(Conliniu'cl from ptifie 12) 

ination. "In particular she should have 
the opportunity during the training 
program to make a systematic assess- 
ment of patients presenting problems 
that are commonly encountered in iso- 
lated northern communities. These 
conditions include the infant with fever; 
all forms of respiratory distress; acute 
abdomen; headache; meningitis; infant 
gastroenteritis and dehydration; high 
risk pregnancies and complications of 
delivery; and venereal disease." 

The report explains: "Nurses em- 
ployed in the North require a highly 
developed ability to relate well with 
others and to understand people of a 
different culture. Each [nurse] needs 
... to realize how people are motivated 
to adopt new values, particularly those 
related to health. ... In general, nurses 
who come closest to this ideal are . . . 
the products of a university program 
in nursing." 

Yet the report notes that nurses in the 
North require abilities beyond those 
generally acquired in Canadian nursing 
educational programs. "The answer is 
not to recruit nurses from other coun- 
tries who may have . . . additional prep- 
aration in midwifery, for this only adds 
one specific area of expertise to a rather 
traditional nursing educational pro- 
gram." 

The report recommends encouraging 
schools of nursing to provide a one- 
month northern experience for their 
students, with the help of federal funds. 
It would also be advisable "to establish 
one program, enrolling 10 nurses, on 
a trial basis in one institution with 
subsequent programs developed in a 
year's time." A suitable institution for 
this type of program, the report points 
out, would be a university with a med- 
ical school and a school of nursing, 
preferably offering the program through 
a continuing education or similar de- 
partment. 

Entrance requirements to this pro- 
gram would be registration as a nurse 
in Canada and preferably one year's 
experience in nursing. "Selection of 
candidates for the training program 
should be made by a committee com- 
posed of representatives of the edu- 
cational institution and medical serv- 
ices." the report adds. 

A suggested outline of course content 
for the approximately four-month train- 
ing period proposes: obstetrics and 
gynecology (35%); procedures and 
techniques (20% ); pediatrics and com- 
municable diseases (15%); ear, nose 



and throat and ophthalmology (10%); 
pharmacology and community habits of 
Eskimos and Indians (10%); and chest 
conditions (10%). 

One strong recommendation is that 
nurses who complete the program re- 
ceive a diploma, certificate, or credits 
from the university. 

The committee members were Dr. 
Dorothy Kergin; Dr. W.D. Dauphinee, 
Royal Victoria Hospital, Montreal; 
Dr. Fernand Hould, Laval University, 
Quebec; Huguette Labelle, Vanier 
School of Nursing, Ottawa; Pauline 
Laurin, Ouebec region, and Anne Wid- 
er, Yukon zone, department of national 
health and welfare; Dr. James Wiley, 
University of Ottawa; and Dr. K.O. 
Wylie, University of Manitoba, Win- 
nipeg, Manitoba. 



National Health Conference 
Focuses On Physician's Assistant 

Ottawa— Although the National Con- 
ference on Assistance to the Physician, 
called by the department of national 
health and welfare April 6-8, may not 
have reached the final answer on the 
question of the need for a physician's 
assistant, it did challenge the status quo 
of the health care system. 

Dr. Gilles Paquet of the department 
of economics at Carleton University 
in Ottawa, said: ". . . the whole debate 
about physician's assistance really 
[involves]... a restructuring of the 
health care system and of power within 
it. We cannot have change without 
changing: if to do so we have to slaugh- 
ter some sacred cows, let the slaughter 
begin." 

Participating in the three days of 
group workshops, plenary sessions, 
open forum, and panel discussions were 
some 1 30 invited participants: uni- 
versity educators; government con- 
sultants; researchers; representatives 
of medical, nursing, labor, and con- 
sumer associations; lawyers and econo- 
mists; hospital directors; and a sprinkl- 
ing of practicing nurses and physicians. 

Of some 30 health care needs indenti- 
fied by the 10 workshop groups on the 
first day and reported at a plenary 
session the following morning, the 
most basic need seen was for more 
ready access to the health care system. 
Also singled out were needs to: integrate 
preventive medicine within one com- 
prehensive health care system; include 
other professions, in addition to nurses, 
as possible physicians' assistants, but 
prevent these assistants from being 
exploited for physicians' profit; re- 
distribute existing professional person- 
nel within and between regions; recog- 
(Conliniu'il on pn^-c 16) 
MAY 1971 



the shape of change: 



ohalleise 



A New Book! 



Given-Simmons 



NURSING CARE 

OF THE PATIENT WITH 

GASTROINTESTINAL DISORDERS 



A New Book! Rodman et al 

THE PHYSIOLOGIC 

AND PHARMACOLOGIC BASIS 

OF CORONARY CARE NURSING 



The first text in this specific area, this compact yet 
detailed book provides a solid foundation for effective 
specialized care. Its practical discussions stress the nurse's 
role in observation, interpretation, and intervention, clearly 
showing how to evaluate patient needs and implement 
comprehensive nursing care plans. The logical systemic 
approach clearly outlines disorders of the gall bladder, 
pancreas and liver as well as the alimentary tract itself. The 
focus is on the many factors underlying nursing actions: 
pathophysiologic alterations, clinical symptoms, require- 
ments of diagnostic tests, medical and surgical treatment. 

By BARBARA A. GIVEN, R.N., B.S.N. , M.S., Assistant Professor of 
Nursing, Michigan State University, East Lansing: and SANDRA J. 
SIMMONS, R.N., B.S.N. , M.S., Assistant Director, Education and 
Training, The Ohio State University Hospitals, Columbus. January, 
1971. 271 pages plus FM l-XII, 7" x 10", 70 illustrations. Price, 
$10.50. 



Specifically written for the nurse's professional orien- 
tation and level of knowledge, this unusual text delineates 
the special information, understanding, and skills needed 
for effective coronary care. While furnishing the necessary 
core of scientific and technical knowledge, it emphasizes 
the nurse's role rather than complex instrumentation and 
technology. Correlating clinical information with nursing 
care, this challenging book presents all aspects of coronary 
disease, from basic anatomy of the heart to diagnosis and 
therapy of specific conditions. It carefully examines the 
nurse's place on the CCU team. Expand your students' 
ability at this upgraded level ~ make this unconventional 
new book your choice next semester! 

By Theodore Rodman, M.D., Ralph M. Myerson, M.D.; L. Theodore 
Lawrence, M.D.; Anne P. Gallagher, R.N., B.S.N. , M.S.N. ; and 
Albert J. Kasper, M.D. May, 1971. Approx. 248 pages, 7" x 10", 
103 illustrations. About $9.40. 



New 5th Edition! Anderson 

Newton's GERIATRIC NURSING 

Help your students understand the special needs of the 
elderly, and introduce them to sound nursing principles and 
practice! A major revision, the new 5th edition of this 
challenging text reflects the many social, economic, and 
scientific forces which have profoundly altered the lives of 
all aged persons in recent years. Perceptive discussions stress 
health maintenance, preventive care, and the therapeutic 
importance of respect and consideration for the aged as 
responsible individuals. A new chapter explains the often 
difficult relationship of the nurse to ill, elderly patients. 
The expanded material on psychiatric care now focuses on 
problems caused by cerebral functional deficits, rather than 
on specific psychoses. 

By HELEN C. ANDERSON, R.N., M.N., Clinical Nursing Section 
Chief, New York Medical College Center for Chronic Disease, Bird 
S. Coler Hospital, New York, N.Y. June, 1971. 5th edition, approx. 
384 pages, 7" x 10", 59 illustrations. About $9.75. 



New 2nd Edition! lorio 

PRINCIPLES OF OBSTETRICS AND 
GYNECOLOGY FOR NURSES 

The only text to combine these two closely related 
subjects, this careful revision features a new principles- 
centered approach. Encouraging your students to develop a 
thoughtful problem-solving attitude, this thoroughly up- 
dated material stresses physiologic and psychologic implica- 
tions of the reproductive cycle. It follows a logical sequence 
from a basic outline of the reproductive process through 
problems of the menopause. New information includes 
timely discussions of phototherapy for jaundice in pre- 
mature infants, Rh sensitization, abortion by saline injec- 
tion, and trends in family planning. Its many new illustra- 
tions include dramatic photographs of actual childbirth, 
showing the father participating. 

By JOSEPHINE lORIO, R.N., B.S., M.A., Associate Professor of 
Nursing, Seton Hall University School of Nursing, South Orange, 
N.J. April, 1971. 2nd edition, approx. 396 pages, 6%" x 9%", 171 
illustrations. Price, $9.75. 



MOSBY 



TIM 



MIRROR 



MAY 1971 



THE C.V MOSBY COMPANY. LTD • B6 NORTHLINE ROAD • TORONTO 374. ONTARIO. CANADA 

THE CAf^ADIAN NURSE 15 



news 



A Hug For Untario's New neaitn /viinisier 



(Coiiliiuu'cl from pa^c 14) 

nize that the fee for service which re- 
wards volume can be an obstacle to the 
delegation of tasks by the medical pro- 
fessions and an obstacle to their accept- 
ance of assistants; get all practicmg 
health professionals working together 
as a team to meet community needs; 
and improve continuity of care for 
individuals between institutional and 
community services. 

But the groups saw no need for a 
completely new health professional, 
although there was consensus on the 
need to extend the training and role 
of existing health professionals. The 
nurse was often referred to throughout 
the three days in relation to such an 
extended role, with particular recogni- 
tion paid to the work of the public health 
nurse and nurses in the north. 

Dr. Maurice LeClair, deputy mini- 
ster of national health, told the con- 
ference: "The primary care physician 
should receive top priority in any at- 
tempt to make increased assistance 
available to the physician. The reg- 
istered nurse is the logical person to 
provide this assistance but ... the 
problem lies more with the legal, econ- 
omic and professional implications of 
providing this assistance than it does 
with the inadequate or inappropriate 
training of the nurse." 

During the final morning open fo- 
rum. Dr. LeClair, emphasizing that he 
was presenting a personal viewpoint, 
said the conference did not provide a 
final answer to the question of assistance 
to the physician. He added that the 
government had no new money for 
training another health professional. If 
something new were to be phased into 
the health care system, he said, some- 
thing else would have to be phased out. 
In reply to the deputy minister, Dr. 
John Evans, dean of medicine at Mc- 
Master University, expressed his con- 
cern about Dr. LeClair's "reticence 
about moving ahead." Dr. Evans said it 
would be disappointing if there is not an 
opportunity to broaden the system — to 
move into team practice and expand 
the role of the nurse. Sometimes ex- 
penditures are required to get a pro- 
ject rolling, but eventually they pay 
off, he continued. 

The conference proceedings and 
results were well summed up by Dr. 
George Szasz of the University of Brit- 
ish Columbia. He questioned the reality 
of what was done at the conference, as 
few practitioners were present. And he 
said the physician has come to realize 
16 THE CANADIAN NURSE 




Who said nurses don't embrace politics? If it's true, this nurse is certainly an 
exception. Maureen Kearney, Miss Young Progressive Conservative of Ontario 
and a student in nursing education at the University of Ottawa, made the most 
of the one-day visit to Ottawa March 1 8 of Ontario's minister of health, A.B.R. 
Lawrence. Maureen, active in the party since she was 1 8, is also second vice- 
president of the Ottawa and District YPC association — one of two women on 
this executive. She finds that women aren't taken seriously enough in politics. 
Nor do many nurses become actively involved in political parties, she says. 
But she is doing all she can to change the status quo! 



that "the sun doesn't rise and set on 
him." 

A further report of this conference 
will be given in the June 1971 issue 
of The Canadian Nurse. 



RNABC Wants Change 
In Abortion Legislation 

Vancouver, B.C. — The Registered 
Nurses' Association of British Colum- 
bia supports liberalization of abortion 
legislation in Canada so that the final 
decision about abortion can be made 
by a woman and her doctor. In a posi- 
tion paper on abortion, the RNABC 
supports a nurse's right to abstain from 
participating in the nursing care of 
patients seeking, having, or recovering 
from a therapeutic abortion except in 
emergency situations. 



The association is urging federally 
supported research programs on contra- 
ception and dissemination of birth 
control information, because it believes 
that abortion should not replace other 
methods of birth control. The RNABC 
does not favor taking abortion out of 
the Criminal Code entirely, instead it 
wants section 237 of the Code amended 
and retained to protect society from the 
illegal abortionist. 

Provincially the association will 
encourage establishment of "pregnancy 
clinics" in public health units, availa- 
bility of birth control information in 
hospital maternity units, and mandatory 
"sex education-family life" courses in 
the public school system. 

The RNABC believes that the pro- 
vision of competent nursing care for 
patients having therapeutic abortions 
iCoiiliiiiii'cl Dii pa.vi' 18) 
MAY 1971 



the shape of change: 



iHMvalioi 



A New Book! Mclnnes 

THE VITAL SIGNS 

A Programmed Presentation 

Including Material on the Apical Beat 

This effective introduction explains basic concepts and 
scientific rationale while it familiarizes students with the 
use of common equipment through actual practice in 
measuring temperature, pulse, respiration, and blood pres- 
sure. 

By MARY ELIZABETH MclNNES, R.N., B.Sc.N., M.Sc.(Ed.), 
Instructor in Nursing. St. Joseph's School of Nursing. Hamilton, 
Ontario. Canada. October. 1970. 95 pages plus FM IXII. 7" x 10", 
35 illustrations. Price. 85.20. 



New 5th Edition! Price 

A HANDBOOK AND CHARTING 
MANUAL FOR STUDENT NURSES 

A timesaving tool for you and your incoming students, 
this flexible new edition concentrates on basic study skills 
and rules for legible, accurate record-keeping. A radical 
departure from previous editions, the lengthy chapter on 
charting methods points out significant changes in the 
content and organization of nurses' notes, patient records, 
and other clerical procedures. 

By ALICE L. PRICE, R.N., M.A. June, 1971. 5th edition, approx. 
232 pages, S'/j" x 11", 74 illustrations, 5 in 2color. 



New Stti Edition! Jessee 

SELF-TEACHING TESTS IN 
ARITHMETIC FOR NURSES 

This popular manual helps your students develop a 
strong background in basic applied arithmetic, in class or by 
independent study. This flexible new edition places the 
achievement tests and their answers at the back of the 
book, where you can easily remove them for separate use. 
A free answer booklet is furnished with each copy of this 
helpful guide. 

By RUTH W. JESSEE, R.N., Ed.D., Chairman, Department of 
Nursing Education, Wilkes College. WilkesBarre, Pa. June, 1971. 
8th edition, 212 pages plus FM IXII, 7%" x lOVi", 21 illustrations. 
Price, $5.00. 



A New Bool<! Poland-Sanford 

ADJUSTMENT PSYCHOLOGY 
A Human Value Approach 

The first non-technical introduction to interpersonal 
relationships and social adjustment, this thoughtful pro- 
grammed guide can help your students develop a positive 
approach to personal interaction — a basic nursing skill! 

By RONAL G. POLAND, Ph.D., formerly Lecturer and Consultant, 
Division of Continuing Education, University of Colorado. Boulder; 
and NANCY D. SANFORD. R.N., M.S.. Instructor of Psychiatric 
Nursing, St. Luke's Hospital School of Nursing, Denver, Colo. 
February, 1971. 233 pages plus FM l-X, bV^" x B'/i". Price, $5.15. 



A New Bool<! Sobol-Robischon 

FAMILY NURSING: A Study Guide 

Representing a wide range of age groups and social 
situations, realistic case studies of 14 families provide a 
dynamic developmental view of health care needs and 
problems. More than 700 questions guide creative study. 

By EVELYN G. SOBOL, R.N., A.M., Assistant Professor, Depart- 
ment of Nursing, Bronx Community College, The City University of 
New York; and PAULETTE ROBISCHON, R.N., Ph.D.. Consultant 
in Nursing Education, Department of Baccalaureate and Higher 
Degree Programs, National League for Nursing. November, 1970. 
148 pages plus FM IXII, 7" x 10". Price, $6.25. 



New 2nd Edition! YoungBarger 

LEARNING MEDICAL TERMINOLOGY 
STEP BY STEP 

Thoroughly revised and updated, this highly popular 
book enables your beginning students to build a workable 
medical vocabulary based on understanding rather than 
memorization. The new 2nd edition includes 23 new terms 
and their definitions, and all-new illustrations! 

By CLARA GENE YOUNG. Retired Technical Editor and Writer 
(Medical), U.S. Civil Service; and JAMES D. BARGER. M.D., 
F.C.A.P., Pathologist, Sunrise Hospital Medical Center. Las Vegas, 
Nev. July, 1971. 2nd edition. 325 pages plus FM IXII, 7" x 10". 39 
illustrations. About $9.35. 



M05BY 



TIMES MIRROR 



MAY 1971 



THE C.V MOSBY COMPANY. LTD. • 86 NORTHLINE ROAD • TORONTO 374, ONTARIO. CANADA 

THE CANyfDiAN NURSE 17 




iContiniic'il from ptif^c 16) 

is the responsibility of the nursing pro- 
fession, but it also recognizes that nur- 
ses, as individuals, hold certain moral, 
religious or ethical beliefs about abor- 
tion and may in good conscience be 
compelled to refuse involvement. The 
association supports the right of a nurse 
to withdraw from this situation without 
being subjected to censure, coercion, 
termination of employment, or other 
forms of discipline. Health facilities 
should make plans for staffing with 
personnel who are willing and compe- 
tent to care for therapeutic abortion 
patients. 

In emergency situations, the patient's 
right to receive the necessary nursing 
care would take precedence over ex- 
ercise of the nurse's individual beliefs 
and rights until other personnel could 
be secured. 

Winnipeg Nurses Seek Re-Hearing 
Of Bargaining Application 

Winnipeg, Man. — Registered nurses 
at the Winnipeg General Hospital have 
applied for a re-hearing following the 
denial of their application for certifica- 
tion as a bargaining unit by the Manito- 
ba Labour Board in February. The 
board dismissed the application on 
the basis that the unit applied for was 
inappropriate for collective bargaining. 

The hospital management had claim- 
ed the unit applied for was inappro- 
priate, wrongly defined, and should 
include licensed practical nurses, regis- 
tered psychiatric nurses, and nursing 
technicians. At a meeting of the Win- 
nipeg General Hospital Registered 
Nurses" Association it was unanimously 
agreed that the initial stand be continu- 
ed, that only registered nurses employ- 
ed by the hospital comprise the bargain- 
ing unit. 

Prior to this application the Man- 
itoba board had approved certification 
for six collective bargaining units com- 
prised of registered nurses only. At 
present all nurses' bargaining units 
in Canada contain registered nurses 
only. 

In a statement the Manitoba Asso- 
ciation of Registered Nurses said: 

"We acknowledge the contribution 
made by other members of the nursing 
team, but we believe that quality nurs- 
ing care can best be provided by the 
registered nurse. The registered nurse 
and the licensed practical nurse are 
two distinct categories of nursing per- 
sonnel, prepared for different levels 
of practice. 

18 THE CANADIAN NURSE 



"The MARN is in agreement that 
eventual alliance of all nurses is desir- 
able, but believes that this must be 
accomplished through a well planned 
program. A study of this proposal is 
underway between the groups con- 
cerned. A forced togetherness at this 
time might well be detrimental to the 
long-range goals of these three groups 
of nurses." 

The Manitoba Hospital Association 
resolved at its annual meeting in De- 
cember 1970, to request that the as- 
sociation of registered nurses, licensed 
practical nurses, and psychiatric nurses 
study the possibility of consolidating 
legislation relating to nursing personnel. 

CEGEP Teachers Attend 
ANPQ Workshops 

Montreal, P.Q. — The Association o1 
Nurses of the Province of Quebec has 
been holding a series of workshops for 
CEGEP teachers. Rita Lussier, ANPQ 
nursing service consultant, arranged 
the workshops, which are completed 
by a week's study course. 

Some workshop themes included 
maternal care, psychiatric nursing care, 
and medical-surgical nursing care. As 
well as objectives the workshops dis- 
cussed program 1 80 of the nursing tech- 
niques option. 

Beginning in February, the work- 
shops will be held until late June in 
Montreal, Quebec City, and Chicoutimi. 

NBARN Interprets 
Brief To Members 

Fredericton, N.B. — The New Bruns- 
wick Association of Registered Nurses 
ad hoc committee made a series of 
chapter visits in March and April to 
explain the brief prepared by the com- 
mittee and presented to the provincial 
study committee on nursing education. 
This brief "could determine the future 
of nursing in the province," said an 
NBARN release. "One vital aspect 
will be the study committee's recom- 
mendations regarding NBARN's legal 
authority." 

NBARN felt it was important that 
members understand what authority 
their association has and what the 
implications would be if any change 
in this authority were suggested. The 
method of interpretation used during 
the visits included a review of the prin- 
ciples behind the recommendations. 

Another NBARN activity this spring 
was the holding of a second series of 
workshops on the legal aspects of nurs- 
ing. Again sponsored by the social and 
economic committee, the series expand- 
ed on material covered in the fall of 
1 970. Topics covered were: malpractice 
insurance, both coverage and exclu- 
sions; review of practices initiated as a 
result of the statement on medical- 



nursing procedures; the legal responsi- 
bility of nurses working in intensive care 
units and other specialized areas; the 
nurse as a witness; and privileged com- 
munication. 

Head nurses attended a March work- 
shop on rituals and routines at the Adult 
Education Institute, Memramcook, 
N.B. Workshop leader was Pamela 
Poole, nursing consultant, department 
of national health and welfare. The 
NBARN nursing service committee 
planned the workshop as an opportunity 
for head nurses to work with Miss Poole 
in a critical evaluation of nursing rou- 
tines. 

in group discussions the nurses were 
asked what they would change about 
physical care routines, food service 
routines, admission and discharge of 
patients, communication to patients, 
and medication routines. They continu- 
ed their discussion with an assessment 
of the need for change and the develop- 
ment of a plan for the implementation 
of change. 

Ottawa U. Nursing Students 
Polish Debating Skills 

Ottawa — Students in nursing educa- 
tion at the University of Ottawa hotly 
debated two resolutions befofe.a critical 
audience of fellow students March 17. 

The auditorium at the National De- 
^■ence Medical Centre resounded with 
applause throughout the two debates. 
In the first, six students argued whether 
or not it is the responsibility of the 
employing agency to provide inservice 
education to enable the graduate of a 
two-year program in nursing to function 
as a staff nurse. The six speakers in the 
second debate questioned whether the 
graduate of a two-year program should 
function only as a team member in the 
public health agency. 

Arguing for the affirmative in the 
first debate. Edith Gange-Harris, a 
nursing counselor on leave from the 
department of national health and wel- 
fare, said it is nursing service admin- 
istration that must pattern the perform- 
ance of nursing personnel for efficiency, 
which can be achieved and maintained 
only by inservice education. This is the 
most productive, simple, and cheap 
tool for an agency, she added. Any 
administration that recognizes the re- 
wards of increased productivity and 
does not provide inservice education for 
the RN, "is not fulfilling its responsi- 
bility to the patient, staff, and com- 
munity." 

Lillian Smith of the negative team 
argued that since the hospital has allow- 
ed nursing education to use its facilities 
without any service demands on nurses 
so nurses can be better educated, the 
hospital has the right to expect a finish- 
ed product. 

(Continued on page 21) 
MAY 1971 




* 



Your written guarantee of quality 



Each prescription you fill is an exercise of your professional 
judgment. The drug you dispense is vital to your cus- 
tomers' health and well-being. What may seem to be 
minor differences in dosage form, particle size, solubility, 
and rate of absorption may make major differences in 
therapeutic efficacy. When the choice is yours, you want 
to dispense the best. 

* ILOSONE 250 mg. (erythromycin estolate) 




Eli Lilly and Company (Canada) Limited, Toronto, Ontario 




This mmft take 
a minute 

Nurses themselves, in time-studies*, established FLEET as 
"the 40-second enema". Compared with the old-fashioned 
method, FLEET ENEMA* saves the nurse an average of 27 
minutes per patient — not to mention all the drudgery. 
FLEET disposables are pre-lubricated, pre-mixed, pre- 
measured and individually packed. Everything moves 
better with FLEET. 

Three disposable forms: Adult (green protective cap). 
Pediatric (blue cap), and Mineral Oil (orange cap). 



WARNING: Not to be used when 
nausea, vomiting or abdominal pain 
is present. Frequent or prolonged 
use may result in dependence. 
CAUTION: Do not administer to chil- 
dren under two years of age except on 
the advice of a physician. In dehy- 
drated or debilitated patients, the 
volume must be carefully deter- 
mined since the solution is hyper- 
tonic and may lead to further dehy- 
dration. Care should also be taken 
to ensure that the contents of the 
bowel are expelled after administra- 
tion. Repeated administration at 
short intervals should be avoided. 




Full intormalion on request. 
•Kehlmann, W.H.: Mod. Hasp. 
84:104, 1955 



FOUNDED IN CANADA IN 1899 
CHARLES E. FROSST & CO. 
KIRKLAND (MONTREAL) CANADA 



news 



(Conliiuwclfrom page 18) 

The negative team then proposed 
that the graduate of a two-year program 
serve a six-month graduate internship 
in the hospital with which she has been 
affihated; write registration examina- 
tions after this internship; worl< a 37 '/2 - 
hour week; and be paid by, and receive 
the benefits of, the hospital on a grad- 
uate nurse level. As part of this plan, 
the nursing school would supply and 
pay a qualified nurse teacher who would 
rotate the various services and shifts 
with the interns. 

The three judges chose the affirm- 
ative as the winning team in this de- 
bate. 

In the second debate, Oksana Mar- 
tyniuk, a speaker for the negative side, 
asked whether the two-year graduate 
should be stifled and not allowed to 
develop to her fullest potential. The 
public health agency, she insisted, 
should "harness motivations already 
there and not just confine the nurse to 
team member." To her contention that 
"a nurse is a nurse is a nurse," the af- 
firmative replied that a nurse is a nurse 
— but not necessarily a leader. It was 
the three negative speakers who con- 
vinced the judges. 



Poor Response To MARN Survey 
Could Mean Little Unemployment 

Winnipeg, Man. — As few replies have 
been received to the recent survey on 
unemployment made by the Manitoba 
Association of Registered Nurses, the 
association is assuming there is no lack 
of employment for nurses in the prov- 
ince. 

MARN public relations officer, T.M. 
Miller said, "On the other hand it might 
be just a matter of procrastination." 
MARN is anxious to have a picture of 
the employment situation in the prov- 
ince and urges registered nurses unable 
to find employment to contact the 
association. 

Quebec Nurses' Union 
Conducts Telephone Survey 
Of All Quebec Nurses 

Montreal, P.Q. — The United Nurses, 
Inc., one of three nurses' unions in 
Quebec, began conducting a telephone 
survey of all 30,000 nurses in the prov- 
ince in March. Nurses were also urged 
to call the union. 

Union president Gloria Blaker said 
the survey, taken because of the serious 
implications for the union's membership 
in the recommendations of the Caston- 

MAY 1971 



guay-Nepveu Commission Report, 
was intended to obtain information to 
help the union do a better job represent- 
ing nurses at the bargaining table. 
■■. . . there must emerge a stronger 
representation [ and ] . . . a more united 
voice for the . . . negotiations," she 
added. 

"The present collective agreement 
covering thousands of nurses and signed 
with the government and the hospitals 
association will end on June 30. From 
that date new negotiations will be taking 
place and the government wishes them 
to be held with a single union," Mrs. 
Blaker said. 

In explaining where nurses stand on 
the application of the Castonguay re- 
port, Mrs. Blaker says most nurses are 
unhappy about the lack of a proper 
definition of their work. ". . . one of 
the results of medicare has been to 
throw huge additional workloads onto 
nurses; yet the definition of that work 
varies from one hospital to the next, 
there is inadequate legal definition of 
nursing acts . . . and there are serious 
problems in terms of professional re- 
sponsibility and the precise role we 
play in the health team." 

The United Nurses, founded in De- 
cember 1966, has close to 6,000 mem- 
bers in 40 hospitals and health agencies 
in the greater Montreal area and the 
Eastern Townships. The other two 
unions in the province are I'Alliance 
des Infirmieres of the Confederation of 
National Trade Unions (CNTU) and 
SPIQ, Federation des Syndicats Pro- 
fessionnels des Infirmieres du Quebec. 

The Eyes Have It — 

With Mobile Care in Newfoundland 

Toronto, Ont. — The first mobile eye- 
care unit in Canada is now in service 
in Newfoundland, said the Ontario 
Medical Review in its February issue. 
The unit will be used and maintained 
by the Newfoundland and Labrador 
Division of the Canadian National 
Institute for the Blind to serve remote 
areas where proper eye care has not 
been available. 

The credit for this project goes to 
Dr. Ellis Shenken, a Toronto oph- 
thalmologist, the Weston Lions. Club, 
Weston, Ont., and the CNIB. Dr. Shen- 
ken supervised the planning and tested 
the unit for about three months before 
it was shipped. The service club donated 
$20,000 to provide the special truck, 
and CNIB purchased ophthalmic equip- 
ment worth $10,000. 

The unit is fully equipped for com- 
plete medical eye examinations, minor 
eye surgery, glaucoma, and amblyopia 
surveys. The truck has heating and air- 
conditioning, and specially constructed 
access stairways, said the article. It is 
staffed by a driver-secretary, a register- 
ed nurse, and an ophthalmologist. 







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THE CANADIAN NURSE 21 





For nursing 
convenience... 

patient ease 

TUCKS 

offer an aid to healing, 
an aid to comfort 

Soothing, cooling TUCKS provide 
greater patient comfort, greater 
nursing convenience. TUCKS mean no 
fuss, no mess, no preparation, no 
trundling the surgical cart. Ready- 
prepared TUCKS can be kept by the 
patient's bedside for immediate appli- 
cation whenever their soothing, healing 
properties are indicated. TUCKS allay 
the itch and pain of post-operative 
lesions, post-partum hemorrhoids, 
episiotomies, and many dermatological 
conditions. TUCKS save time. Promote 
healing. Offer soothing, cooling relief 
in both pre-and post-operative 
conditions. TUCKS are soft 
flannel pads soaked in witch hazel 
(50%) and glycerine (10%). 



TUCKS — the valuable nur- 
sing aid. the valuable patient 
comforter. 




w 



Specify the FULLER SHIELD'*' as a protective 
postsurgical dressing. Holds anal, perianal or 
pilonidal dressings comfortably in place with- 
out tape, prevents soiling of linen or cloth- 
ing. Ideal for hospital or ambulatory patients. 



WINLEY-MORRIS l% 

MONTREAL 



TUCKS Is a trademark of the Fuller Laboratories Inc. 
22 THE CANADIAN NURSE 



ICN Prepares Draft 
On Status Of Nurses 

Geneva, Switzerland — The Interna- 
tional Council of Nurses' professional 
services committee has begun a draft 
on what it believes should be contained 
in the "special international instrument 
on the status of nursing personnel," a 
document to be prepared in final form 
by the International Labour Organiza- 
tion, in cooperation with the World 
Health Organization. Work on the out- 
line occupied the major part of a three- 
day meeting of the committee on Feb- 
ruary 10-12, 1971. 

ICN member organizations were 
consulted so the presentation of the 
draft would reflect what nurses wish 
to see included in the final document, 
which will be tabled for ratification by 
various governments. 

The ICN board of directors referred 
to the committee the study of "auxiliary 
nursing personnel and their position in 
relation to national nurses' associa- 
tions." Information for this study will 
bring ICN up-to-date on developments 
in many countries and possibly indicate 
future, trends m membership, not only 
of national nurses' associations but of 
ICN. The committee will give a pro- 
gress report at the Council of National 
Representatives meeting planned for 
Dublin in July. 

The committee was asked by the 
board to make suggestions for revision 
of the ICN code ^ethics. Three com- 
mittee members, chairman Ingrid Ham- 
elin of Finland, Dr. Rebecca Bergman 
of Israel, and Margery Westbrook of 
the United Kingdom, met as a subcom- 
mittee to consider code revisions. Their 
report was accepted by the committee. 
The final document will be voted on at 
the CNR meeting in 1973. 

Also at the request of the board the 
committee is considering the role of 
ICN in nursing research. I he com- 
mittee agreed that ICN has a role m 
research and that research projects 
should be selected on a priority basis. 

At its 1970 meeting the board re- 
ferred to the committee a request from 
a member association to study the role 
of the qualified nurse in the decision 
procedure in hospital organization. 
The committee will recommend to CNR 
that ICN reaffirm the relevant state- 
ments contained in the "statement on 
nursing education, nursing practice, 
and service and the social and economic 
welfare of nurses." 

These are: "Nursing service is im- 
proved through a system within which 

(Continued on puf;e 24) 
MAY 1971 



NEW EDITION OF 




Edition 



Maintaining the 

high goals set by 

earlier editions, this 

famil y- focused text is 

^expanded and updated 

in line with new medical 

pxjncepts and concomitant 

irsing practice. All content 

is directed toward the total 

health and well- bein g of 

the mother and infant. 

■ Elise Fitzpatrick, R.N., M.A.; 
SharonR. Reeder. R.N., M.S.; and 
Luigi Mastroianni, Jr., M.D., F.A.C.S., F.A.C.O.G. 

700 Pages -320 Illustrations- April, 1971 • $9.50 



J, B. Lippincott Company of Canada Ltd!^^ 60 Front Street, West 



Toronto 1 , Ontario 



Next Month 
in 

The 

Canadian 
Nurse 



• Report of CNJ 
Readership Survey 

• Do You Have a Bad 

Trip If You Go to hospital? 

• Travel Seminar 
to the North 



^ 

^^F 



Photo credits for 
May 1971 



Crombie McNeill Photography, 
Ottawa, p. 7 

Photo Features, Ottawa, pp. 8, 16 

RNABC News, Vancouver, p.24 

Canada Wide Feature Service 
Ltd., Montreal, p. 48 

Armour Landry, Montreal, 
pp.49, 50 



It Wasn't Quite The Stanley Cup! 




I II iii«"jii" . k 






It might not have been the same as Hockey Night in Canada, in fact, some of 
the players wore boots. Still, the game was hotly contested. The Registered 
Nurses' Association of British Columbia's February bulletin gives this account 
of "Schmocicey Nite" in Powell River, B.C. It was a nurses vs. doctors grudge 
match following the doctors' triumph over the nurses at Softball last summer. 
The nurses were out to get the doctors from the start, but it was an uphill battle 
as the doctors took a 1-0 lead early in the game. Then a strategic time-out was 
called. The nurses passed around some "refreshment" in an intravenous bottle. 
This was the downfall of senior medical staff, for they were distracted and the 
wily nurses carried off the doctors' star net minder on a stretcher. Game Over! 



24 THE CANADIAN NURSE 



(Continued from page 22) 

nursing leadership, is exercised and 
optimum use made of nursing person- 
nel" and "Nurses should participate in 
the planning and administration of 
health and nursing services at national 
and local levels." 

The committee reviewed and assem- 
bled material related to the emergence 
of a new category of health worker — 
the physician's assistant. The issue was 
raised by a member association and 
referred to the committee by the board. 

The committee received a report 
from headquarters staff on the success- 
ful international seminar on nursing 
legislation held in Warsaw, Poland, in 
July 1970. The committee initiated 
the project and will recommend to the 
CNR that similar seminars be held in 
other countries. 

Other members of the professional 
services committee are: Laura Barr, 
Canada; Renee de Roulet, Switzerland; 
and Gertrude Swaby, Jamaica. Also 
attending the meetings were Lily Turn- 
bull, chief nursing officer, WHO; 
Yvonne Hentsch, director of the nurs- 
ing bureau of the league of Red Cross 
Societies; and ICN president, M. Kruse. 



ION Post Open 
In Switzerland 

Geneva, Switzerlarid — The Interna- 
tional Council of Nurses has a nurse 
advisor position open on the execu- 
tive staff of the council. Applicants 
must be: registered nurses in own coun- 
try; members of an ICN member as- 
sociation; willing to take up residence 
in Geneva, Switzerland; able to travel 
extensively on behalf of the organiza- 
tion; prepared and experienced (post 
basic) in the fields of nursing service, 
education, or public health; fluent in 
English and with a sound knowledge 
of a second Europen language, prefera- 
bly French or Spanish. 

Send curriculum vitae (including 
experience in nursing association work) 
in English to: Executive Director, 
ICN Headquarters, Box 42, 1211 
Geneva 20, Switzerland. ■§> 



THE RED CROSS IS 
PEOPLE LIKE YOU 
HELPING 
PEOPLE LIKE YOU 



MAY 1971 



for use 
-on the ward 
-in the OR 



-in training 




NEOSPORIN^ 
IRRIGATING 
SOLUTION 

Available; Siefile Ice, Ampoules, 
Boxes of 10 and 100 

INSTRUCTIONS FOR USE 



This pfeparBiion is speciticolly designed for use with 5 cc. 
"three-way" cattieTefs o< *"l*i other catheter systems permit- 
ting continuous irriQsiion of the unnsry bladder. 

1 PREPARE SOLUTION 

Usifig siefile piecaulions, one (1 ) cc. of Neospoim Irriga- 
ting Solution should be added to a 1 ,000 cc, botile of 
sterile isoioH'C saline solution. 

2 INSERT INDWELLING CATHETER 

Catheierize the patient using full sterile precautions. The 
use of sn antibacterial lubricant sucli as Lubasponn* Urethral 
Antibactenal Lubficant is recommended during insertion of 
the catheter 

INFLATE RETENTION BALLOON 

Fill a Luer type syinge with 1 cc. of sterile water or saline 
(5 cc, for balloon, the remainder to compensate for the 
volume required by the inflation channel) Insert symge 
tip into valve ol balloon lumen, in|ect solution and remove 
syringe. 

IpONNECT COLLECTION CONTAINER 

outflov* (drainage) lumen should be aseplicaliy con- 
rcted. via a sterile disposable plastic tub«. to a sterile 
losable plastic collection bag (bottle). 

ACH RINSE SOLUTION 

inflow lumen of the 5 cc "three-way" catheter should 
be connected to the bottle ot diluted Neosporin 
ilion Solution using sterile technique, 

f ADJUST FLOW-RATE 

■or most patients inflow rate of the diluted Neosporin 
Irrigating Solution should be adjusted to a slow drip to 
deliver about 1.000 cc. every twenty-four hours (about 
40 CC per hour). It the patient's urine output exceeds 2 
liters per day it is recommended that the inflow rate be 
adjusted to deliver 2,000 cc of the solution m a twenty- 
four hour period This lequiies the addition ot an ampoule 
ot Neosporin Irrigating Solution to each ot two 1,000 cc, 
bottles of sterile saline solution 

KEEP IRRIGATION CONTINUOUS 

It IS important that irrigation of'the tiladder be continuous 
The rinse bottle should never be allowed to run dry. or the 
inflow d'lP interrupted lO' more than a few minutes. The 
outflow tube should always be inserted into a itenle 



Convenient product identifying labels for use on bottles 

ot diluted Neosporin Irrigating Solution are available in each 
ampoule packing or from your 'B. W & Co.' Representative. 



Burroughs Wellcome & Co. (Canada) Ltd. 









1 


i-o 


^Kt'-\f(i 








1 














1 i 


Jk>*- » 1 


^ 


I 1 






1 









;!GEEI 



Neosporirf Irrigating Solution 



INSTRUCTIONS FOR USE 



Designed especially for the nursing pro- 
fession, this Instruction Sheet shows 
clearly and precisely, step by step, the 
proper preparation of a catheter system 
for continuous irrigation of the urinary 
bladder. The Sheet is punched 3 holes to 
fit any standard binder or can be affixed 
on notice boards, or in stations. 

For your copy (copies) just fill in the cou- 
pon (please print) noting your function or 
department within the hospital. 



Dept, S,P,E. 

Burroughs Wellcome & Co, (Canada) Ltd, 

P,0, Box 500, Lachine, P,0, 

Gentlemen : 

Please send me I I copy (copies) of the N.I.S. Instructions for Use. My department or function 

within the hospital is ■ — 



NAME. 



ADDRESS. 



CITYORTOWN_ 



.PROV. 



I PIWIAC I 

"Trade Mark 

MAY 1971 




Burroughs Wellcome & Co. (Canada) Ltd. 

THE CAr^ADIAN NURSE 25 



names 




Freda Paltiel has 

been seconded by 
the Prime Minister 
to the Privy Coun- 
cil, the cabinet sec- 
retariat. As coordi- 
nator of the federal 
government's exam- 
ination of the status 
of women, she works 
with 25 government departments and 
agencies from a secluded office in the 
East Block of the Parliament buildings. 
Mrs. Paltiel. who was with the de- 
partment of national health and welfare 
doing research on rehabilitation and 
chronic disease, brings to her task a 
sound education in sociology, medical 
social work, and public health, and 
recognized experience in social policy 
research. 



Eva M. O'Connor (R.N., St Mary's 
Hospital School of Nursing, Montreal; 
B.Sc, University of Ottawa) was ap- 
pointed registrar of the New Brunswick 
Association of Registered Nurses, ef- 
fective March 1, 1971. 

Miss O'Conner, a native of New 
Brunswick, returned to her home prov- 
ince following varied experiences in 
nursing service at St. Mary's Hospital, 
Montreal; in Aukland, New Zealand; 
and, most recently, in Tampa, Florida. 

Marie T. Germin (R.N., Misericordia 
Hospital School of Nursing, Edmonton) 
is currently on a two-year tour of duty 
with MEDICO, a service of care, work- 
ing with a 10-member team of doctors, 
nurses, and a technologist stationed at 
Avicenna Hospital, Kabul, Afghanis- 
tan's capital. Her role is that of teaching 
and training Afgahan personnel to 
eventually carry on by themselves and 
train others. 

Miss Germin has worked at hospitals 
in Tofield, Wainwright and Red Deer, 
Alberta, and at Kelowna, B.C. She 
nursed for a year at a mission center 
on Dominica, a West Indian island. 

Jessie Williamson (R.N., St. Boniface 
Hospital, B.S., Columbia University, 
New York) has retired as director of 
public health nursing services of Man- 
itoba, a position she has held for 16 
years. She believes the position should 
be filled by an administrator young 
enough to oversee the childhood of the 
"new order." For her, the community 
26 THE CANADIAN NURSE 



health center concept — the basis of 
a new regional health service system 
planned by the provincial government 
— is just another word for public 
health. 

Pamela E. Poole, nursing consultant, 
health insurance branch of the depart- 
ment of national health and welfare, 
and Rita M. Morin, nursing counsellor, 
public service health division of the 
department of national health and wel- 
fare in Edmonton, are members of the 
1971 board of directors of the Profes- 
sional Institute of the Public Service. 
They represent nursing groups: Miss 
Poole for the Ottawa area, and Mrs. 
Morin for the prairies. 

Nelly Garzon, dean of the faculty of 
nursing at Universidad Nacional de 
Colombia, and LottI Wiesner, president 
ot the Colombian Nurses' Association 
and chief nurse in the Ministry of Public 
Health, both of Bogota, Colombia, 
visited CNA House March 16. Leaders 



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OnAWA, Canada K2P 1E2 




in their field, they are interested in the 
comparative aspects of Canadian and 
Colombian nursing and health needs. 
They were in Canada as guests of CUSO 
to discuss means of facilitating the 
placement of CUSO nurses in Colombia 
and providing relevant in-country 
orientations to newly arrived Canadian 
nurses. 

Dr. Muriel Uprichard 

has been appointed 
head of the school 
of nursing of the 
University of Brit- 
ish Columbia, ef- 
fective July 1 . 

Dr. Uprichard 
brings to her new 
position a distin- 
guished academic background (B.A., 
Queen's University, Kingston; M.A., 
Smith College, Northampton, Mass.; 
Ph. D. (educational psychology) Uni- 
versity of London Institute of Educa- 
tion; and post-doctoral studies in public 
health. University of Michigan, Ann 
Arbor) as well as a rich professional 
experience. She was associate professor 
at the school of nursing, University of 
Toronto until 1965 when she joined the 
faculty of the University of California 
at Los Angeles as senior lecturer in 
nursing and associate research psy- 
chologist. 

In 1964-65, as consultant to the 
Royal Commission on Health Services 
in Canada, Dr. Uprichard was respon- 
sible for the section of the report deal- 
ing with the improvement of patient 
care through more effective utilization 
of nurses. 

In 1948, Dr. Uprichard published 
Three Little Indians, her collection of 
original stories for children. About 
to be published (aided by funds from 
The American Nurses' Foundation) 
is her newest work: The Making of 
Modern Nursing: A Study of Social 
Forces Influencing the Development 
of Professional Nursing. § 



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MAY 1971 




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THE CANADIAN NURSE 27 



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May 11-14, 1971 

Alberta Association of Registered Nurses, 
annual meeting, Banff Springs Hotel, Banff, 
Alberta. 

May 17, 1971 

Canadian Nurses' Foundation, annual 
meeting, CNA House, Ottawa, Ontario. 



May 19-20, 1971 

New Brunswick Association of Regis- 
tered Nurses, annual meeting. Holiday Inn, 
Saint John, N.B. Convention theme: "Pat- 
terns of Health Care in N.B." 



May 26, 1971 

Registered Nurses' Association of British 
Columbia, 59th annual meeting, Bayshore 
Inn, Vancouver, B.C. 



May 21-24, 1971 

Halifax Conference in Creative Drama, 
sponsored by the Canadian Child & Youth 
Drama Association, Dalhousie University. 
Halifax. For further information write: Mrs. 
Susan Loring, Treasurer, CCYDA, 56 Francis 
Street, Halifax, Nova Scotia. 



May 22, 1971 

First reunion of graduates of St. Louis de 
Montfort Hospital School of Nursing, Vanier 
City, Ontario. Send address to: C. Larocque, 
School of Nursing, St. Louis de Montfort 
Hospital, Vanier City, Ontario. 

May 24, 1971 

Final graduation and grand reunion, St. 
Mary's School of Nursing, Sault Ste. Marie, 
Ontario. Graduates and other interested 
persons should write for further details 
to: Mrs. A. McPhee, General Hospital 
Nurses' Alumnae, 941 Queen St. E., Sault 
Ste. Marie. Ontario. 

May 26, 1971 

Saskatchewan Registered Nurses' Asso- 
ciation, annual meeting, Bessborough 
Hotel. Saskatoon, Saskatchewan. 

May 30-|une 1,1971 

Manitoba Association of Registered nurses, 
annual meeting, Dauphin, Manitoba. 



May 31 to June 2, 1971 

University of British Columbia, Division of 
Continuing Education, Course on Nursing 
Service Administration for directors of 
nursing service in all health care agencies. 
Fee: $55.00. For further information write: 

MAY 1971 



Margaret S. Neylan, Associate Professor 
and Director, University of British Colum- 
bia School of Nursing, Division of Continu- 
ing Education, Vancouver 8, B.C. 

June 2-4 1971 

Canadian Hospital Association, National 
convention and assembly, Queen Elizabeth 
Hotel. Montreal, Quebec. 

June 6-10, 1971 

Ninth Canadian Cancer Conference under 
the auspices of the National Cancer Ins- 
titute of Canada, Honey Harbour, Ontario. 

June 7-11, 1971 

Canadian Medical Association, 104th an- 
nual meeting. Nova Scotia. For further 
information: Mr. B.E. Freamo, Acting 
General Secretary, Canadian Medical 
Association, 1867 Alta Vista Drive, Ottawa 
8, Ontario. 

June 9-11, 1971 

University of British Columbia, Department 
of Continuing Education, course on nursing 
education designed f9r educators in schools 
of nursing and health care agencies. Fee: 
$55.00. For further information write: 
Margaret S. Neylan, Associate Professor 
and Director, University of British Columbia 
School of Nursing, Division of Continuing 
Education, Vancouver 8. B.C. 

June 9-12, 1971 

Canadian Psychiatric Association, 21st 
annual meeting, Lord Nelson Hotel, Halifax, 
ivf.S. For further information write: Canadian 
Psychiatric Association, Suite 103, 225 
Lisgar Street, Ottawa 4, Unt. 

June 10-11, 1971 

Symposium on Metabolism and Disease, 
sponsored by the Food and Drug Director- 
ate, Department of National Health and 
Welfare, Talisman Motor Inn, Ottawa. 

June 15-17, 1971 

Registered Nurses' Association of Nova 
Scotia, annual meeting. Nova Scotia Agri- 
cultural College, Truro. Nova Scotia. 

June 21-23, 1971 

Operating Room Nurses of Greater To- 
ronto seventh annual conference. Royal 
York Hotel, Toronto. For further informa- 
tion contact: Miss Marilyn Brown, 2178 
Queen St. E., Apt. 4, Toronto 13, Ontario. 

June 23-25, 1971 

Three-day reunion, Victoria General Hospi- 
tal. Registration: Nurses' Residence, 415 
River Ave., Winnipeg. For further informa- 
tion contact: Mrs. J. Wakely, 426 Centen- 
nial St., Winnipeg 9, Manitoba. 'S' 




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THE CANADIAN NURSE 29 



in a capsule 



Convention-ilis 

We are passing along a message, which 
requires no comment, from the editor 
ot7yas/;/7a/.v. the journal of the American 
Hospital Association. This editorial, 
by James Hague, appeared in the Feb- 
ruary 1 6 issue of the journal. 

"... Alexis de Tocqueville has 
noted the American's strange affinity 
for organizing into associations to 
promote one worthy cause or another 
The years have not changed the valid- 
ity of the Tocqueville's observation. 

"One of the first things an associa- 
tion does is to run an annual meeting 
or convention, gathering its members 



from near and far to conduct all sorts 
of deliberations, and to be bombarded 
with all kinds of lofty notions. 

"These affairs are often wearying 
beyond endurance. One distinguished 
science writer. Doctor Milton Silver- 
man, was exposed to more than what he 
thought was his proper share of these 
extravaganzas, it led him to comment 
that the last day of a convention should 
be eliminated, and this process should 
be carried to its logical conclusion." 

In Mr. Hague's closing words, "After 
just finishing one of these affairs, one 
is inclined to suspect that Doctor Sil- 
verman was quite right." 




30 THE CANADIAN NURSE 



"Phony" words 

The words "Anglophone" and "Franco- 
phone" have been bandied about ad 
nauseam since the B and B Commission 
came into existence. At first we thought 
they must refer to some new gimmick 
put out by Mother Bell, but then we 
learned they applied to those who speak 
English and those who speak French. 

Nowhere in our British or American 
dictionaries could we find these words. 
However, they do appear in Diclion- 
naire Robert, a well-known dictionary 
published in France. 

We still think these words sound 
"phony." And, as one gentleman said 
in a letter to the editor of The Ottawa 
Citizen, if people insist on using these 
words, they should at least take history 
into account. The Saxons, he said, 
played a far more important role in 
history than did the Angles. Therefore, 
he suggested, we should refer to those 
who speak English as "Saxophones." 



Art brightens medical centre 

Three cheers for McMaster Univers- 
ity Medical Centre! it has reason to be 
proud of its efforts to provide its visitors 
with a gallery of paintings by world 
renowned artists. 

Chagall, Dali, and Boulanger are 
just a few of the artists whose works 
have adorned the walls of patient wait- 
ing areas in the completed section of 
the medical center. In March the Beck- 
ett Gallery in Hamilton provided a dis- 
play, and a continuing series of art 
exhibitions are planned. 

The idea is to make the center's 
atmosphere as human and stimulating 
as possible. Evidence of this aim can 
be seen in the colorful treatment of 
walls and the use of pre-shaped masonry 
materials that can be assembled to 
produce varying wall patterns. 

In March there were 62 paintings 
and etchings on show, a number of 
lithographs, serigraphs, acrylics, and 
Eskimo stone cuts. And for those who 
might later think of purchasing a piece 
of art, a price list is on hand. 

McMaster believes this is the first 
time a hospital has provided this kind 
of interest for patients and visitors — 
as well as for the staff who work there 
day in and day out. Whether it is a first 
or not, McMaster deserves congratula- 
tions for taking this imaginative step 
forward. ^ 

MAY 1971 



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CNA annual meeting 



More than 150 nurses attended the 
annual meeting of the Canadian Nurses' 
Association, held in the Chateau Lau- 
rier Hotel, Ottawa, on March 3 1 . Of 
these, 93 were voting delegates repres- 
enting the 1 provincial nurses' associa- 
tions. 

In her opening remarks to the as- 
sembly, CNA President E. Louise Mi- 
ner explained the reason for holding 
an annual meeting.* She then spoke of 
her activities on behalf of the associa- 
tion, remarking that she was "going 
steady with Air Canada." Miss Miner 
said she will spend 17 days in the next 
two months on association business, 
and expressed regret that she cannot 
accept the many invitations she receives 
as CNA president. 

After the roll call had been taken by 
Dr. Helen K. Mussallem, CNA exec- 
utive director, the assembly put business 
aside to honor Dr. Helen G. McArthur, 
wl^ retires this summer as national 
director of nursing services, the Cana- 
dian Red Cross Society. The CNA 
Honorary Citation was presented to 
Dr. McArthur for her outstanding 
contribution to nursing. (See News, 
page 8.) 

Delegates were asked to nominate 
and elect a third member to the com- 



*Since 1922, the CNA has held biennial 
meetings. Now that the association comes 
under the Canada Corporations Act Part 
2 and has been issued Letters Patent, an 
annual meeting is required. (See August 
1970. page 29.) The CNA will combine 
the annual meeting with a convention 
program in 1972 and biennially there- 
after. 
MAY 1971 



mittee on nominations. (Present mem- 
bers are Florence Gass, Nova Scotia, 
and Marie Rice, Ontario.) Sister Mary 
Felicitas, immediate past president of 
CNA, was elected unanimously and will 
serve as chairman of the committee. 

In her report to the annual meeting. 
Dr. Mussallem outlined the action taken 
by the board, its committees, and the 
CNA staff since thfe last general meet- 
ing in Frederiction nine months ago. 
"[We] have been involved in carrying 
out your directives and mandate 'to 
lead, to coordinate, and to advise' 
she said. (The resolutions of the last 
general meeting and action taken by 
CNA are on page 34.) 

Dr. Mussallem reported that CNA 
membership for 1970 was 87,126 — 
an increase of 4,300 over the previous 
year. After speaking briefly about the 
work of the association and its relation- 
ships with other agencies, the executive 
director said CNA is grossly under- 
staffed and is not fulfilling its role to 
its members or to society. 

"In 1963 . . . there were nine nurses 
on staff in national office," Dr. Mus- 
sallem said. "Since that time the pro- 
gram has mushroomed and the number 
of nurse staff decreased. Today there 
are four nurses attempting to carry a 
load far greater in every aspect than in 
1963 .... The great concern is not so 
much that long hours of work are re- 
quired, but that the CNA is not staffed 
to respond to the present social milieu," 
she said. 

Dr. Mussallem then pointed out that, 
excluding the cost of the journals' oper- 
ation, about $4 per member remains 
— the same as it was in 1963. "Anyone 
here will realize the difference between 



purchasing power of $4 in 1963 and 
1971," she said. 

"This is not an appeal for increased 
fees," the executive director told the 
assembly. "But if you share the belief 
that we are not meeting our goals in 
the '70s, some very hard and difficult 
decisions will have to be made on how 
we can stretch the already overstretched 
income dollar .... If this association 
is to meet its potential in an expanding 
role in today's rapidly changing and 
accelerating health services, it cannot 
do so with the present number of senior 
staff. To carry out these responsibilities 
— which include keeping ahead of 
crises and not action at the time of or 
after a crisis — a new and dynamic 
approach is required . . . ." 



Reports of standing committees 

Marilyn Brewer, chairman of CNA's 
standing committee on social and econ- 
omic welfare, read a progress report 
to the delegates. The report discussed 
issues covered by the committee at its 
meeting in November 1970 and recom- 
mendations presented to the CNA board 
of directors at its meeting March 29 
and 31, 1971. (The board also met 
April 1, the day following the annual 
meeting.) 

A directive from the general meet- 
ing in Fredericton last June — to con- 
sider the relationship of standards of 
practice and employment policies — 
was discussed at length by the commit- 
tee. Members saw an urgent need for 
the nursing profession, through CNA, 
to develop a set of standards defining 
the acceptable level of nursing practice. 
(Ki'porl lonliniicd on pane 35) 
THE CAf^ADIAN NURSE 33 



Action on Resolutions from CNA 35th General Meeting 

(For full text, see pp. 26-27, August issue of The Canadian Nurse) 



Resolved that the Canadian Nurses' Association press 
more firmly for representation on the Canadian Council 
on Hospital Accreditation .... 

Action: As CNA's continued efforts to gain membership 
on this body have been unsuccessful, it was decided at 
the October 1970 board meeting to postpone further 
efforts for a few months. 

Resolved that the CNA request the department of na- 
tional health and welfare to call a national confer- 
ence ... to study health matters. . . . 
Action: In response to CNA's request, a national confer- 
ence on assistance to the physician: the complementary 
roles of the physician and nurse, was held in Ottawa 
April 6-8. (See News, page 14.) 

Resolved that the CNA prepare a position paper on the 
introduction of the new categories of workers into the 
health field, namely those referred to as the physician's 
assistant and medical practitioner's associate. 
Action: As an outcome of the stand taken at the October 
1970 meeting of the board of directors, a statement on 
the physician's assistant was submitted to the minister 
of national health and welfare. This stand was supported 
by key organizations and individuals. 



Resolved that the CNA urge the federal government to 
remove the sections relating to abortion from the crim- 
inal code. 

Action: Initially referred by the general membership to 
the board of directors for further study of its implica- 
tions, this resolution was deferred in October to the 
March board meeting to give provincial nurses' associa- 
tions an opportunity to study and report their decisions 
on both its criminal code aspects and the implications 
involved. A statement, based on British Columbia's sub- 
mission, was endorsed in principle by the board and sent 
to the provincial associations who were asked to report 
on the issue by June 20. (See News, page 7.) 

Resolved that the CNA Board of Directors consider as 
a priority ways and means of encouraging the produc- 
tion of textbooks in the French language. 
Action: An ad hoc committee on French textbooks met 
February 1-2 and March 26. (See News, page 7.) 

Resolved that the CNA make a presentation to the 
Federal minister of finance on the white paper on taxa- 
tion. 

Action: A CNA statement was submitted to the minister 
of fmance in July, 1970. His reply gave assurance that 
the CNA would be notified should he wish to discuss 
the proposals further. 

Resolved that a sufficient registration fee be charged to 
allow each registrant to receive the same folio of infor- 
mation as provided for voting delegates; and 
Resolved that all nursing students enrolled full time in 



diploma or university programs be permitted to attend 
CNA general meetings at the reduced student registra- 
tion fee. 

Action: Both resolutions will be taken into consideration 
by the board of directors prior to the 1972 annual meet- 
ing and convention. 

Resolved that the audited financial report of the CNA 

be printed in The Canadian Nurse and L'infirmiere 

canadienne. 

Action: The report was published in the March issue of 

The Canadian Nurse and L'infirmiere canadienne. This 

practice will continue. 

Resolved that there be a committee on legislation of 
the CNA. 

Action: On referral of this resolution by the general 
membership, directors voted that all matters relating to 
legislation be referred for study and action to the execu- 
tive committee, and that it be empowered to request con- 
sultation if needed. 

Resolved that voting delegates De granted the privilege 
of voting for two nominees on the vice-presidential bal- 
lot. 

Action: This resolution has been incorporated into the 
"Rules and Procedures" as defined in the Scrutineer's 
Manual. 



Resolved that the board of directors give serious consid- 
eration to the appointment of a well-qualified nurse to 
assume the role of lobbyist for the CNA. 
Action: At the October 1970 meeting, directors ap- 
proved the employment of the legal firm of Gowling & 
Henderson on a retainer-fee basis. This contract includes 
the surveillance of federal legsilation to provide alertness 
to impending legislation and legal advice on implications 
for the association. 

Resolved that at future general meetings of the CNA, 
program time and facilities be provided so that nurses 
interested in discussing current issues can meet to ex- 
plore them in open forums . . . 

Action: This has been referred to the executive commit- 
tee, which, at the October 1970 board of directors' meet- 
ing, was appointed the program committee for the 1 972 
annual meeting and convention. 

Resolved that the CNA support appropriate measures 
proposed for the control of threats to the health of all 
Canadians and that each member of the CNA . . . assist 
in the solution of these grave threats to life in the world 
today. 

Action: This resolution was drawn to the attention of all 
members of the CNA through publication in the August 
1970 issues of The Canadian Nurse and L'infirmiere 
canadienne. At the board of directors' meeting April I , 
it was decided to send a letter on the subject of pollu- 
tion to the Hon. Jack Davis at the appropriate time. 



34 THE CANADIAN NURSE 



MAY 1971 



The committee recommended that 
CNA social and economic welfare 
goals, as stated in On Record, remain 
unchanged, with the exception of the 
salary goal. For the licensed or register- 
ed nurse, the national salary goal for 
the beginning practitioner was set at 
a minimum of $7,920 a year — a 10 
percent increase over the salary goal 
approved by the board of directors for 
1970. The same differential as in pre- 
vious years was recommended for a 
beginning practitioner of a baccalaure- 
ate program, bringing the national goal 
to $9,360 from $8,640 per annum. 

Also considered by the committee 
were ways of giving further support to 
concerns stated in the CNA brief on the 
federal government's White Paper on 
Unemployment Insurance in the '70s 
to protect the nurses' position as legisla- 
tion is developed. The CNA brief was 
submitted last September to the House 
of Commons standing committee on 
labour, manpower, and immigration. 
Because of changes proposed in the 
government's unemployment insurance 
legislation, the committee discussed the 
needs of unemployed professionals for 
university courses for retraining and the 
exclusion of such courses from the 
Adult Occupational Training Act 
(News, April). 

On the last day of the board meeting, 
Mrs. Brewer discussed her committee's 
report on the federal government's 
White Paper on Income Security for 
Canadians. The report agreed with the 
white paper's proposal to "revise income 
security policies to redirect their em- 
phasis" and [agreed] that income sec- 
urity programs be based on need, and. 
outlined four priorities for CNA. 

These priorities are that CNA: 
• Support the proposed universal flat 
rate benefit for old age security and 
endorse an increased guaranteed income 
supplement for low income persons 65 
years and over. 

•Agree that family allowances be sel- 
ective, that the size of the family be 
MAY 1971 



considered, and that a proposed ceil- 
ing be examined further. 

• Encourage the proposal to improve, 
but decrease dependence on, social 
assistance. 

• Support the basic principle of includ- 
ing nurses in the government's unem- 
ployment insurance plan. 

The report also commended the 
government's recognition that "the 
effectiveness of income security will 
depend in part on the effectiveness of 
other social policies in meeting their 
goals," for example, social welfare 
services, health services, housing, and 
education. 

CNA's board of directors adopted 
this report as the basis for the associa- 
tion's reaction to the White Paper on 
Income Security. The Canadian Nurse 
will report on CNA's brief when it is 
completed. 

In her progress report to the annual 
meeting, Irene Buchan, chairman of 
the committee on nursing service, said 
the CNA board of directors had accept- 
ed the recommendation of the com- 
mittee that the CNA cease to consider 
the development of a pamphlet on team 
nursing because there is a large volume 
of literature already available on the 
subject. 

The other recommendation accepted 
by the board was that CNA give consi- 
deration to the appointment of a nurs- 
ing consultant with special prepara- 
tion in adult education to work with 
CNA membership on staff development 
programs. The committee noted there 
is a great awareness of the impact of 
staff development on the quality of 
health care and staff satisfaction, yet 
a great many agencies are presently 
unable to fulfill the demand on their 
staff for continuing education. The 
committee formed the resolution as a 
means of providing some interim assis- 
tance until more educators can be pre- 
pared in adult education at a graduate 
level. 

Alice Baumgart, chairman of the 



committee on nursing education, pre- 
sented the recommendations of the 
committee acted on by the CNA board 
of directors. The board approved a 
resolution that CNA give urgent atten- 
tion to the setting up of regional con- 
ferences for: nursing administrators 
involved in planning the transition 
from hospital sponsored to educationally 
oriented institutions to familiarize 
them with appropriate strategies to use 
in the process; for faculty who will be 
teaching in educationally oriented nurs- 
ing programs to help them recognize 
and adapt to the different learning con- 
ditions which prevail in educational 
institutions. 

The committee's resolution that 
action on setting up accreditation be 
deferred at this time was carried by 
the board. The committee noted the 
concern expressed about the adequacy 
of existing controls over the quality of 
educational programs as provided by 
statute and association approval me- 
chanisms. It also noted there seems to 
be mounting concern about the merits 
of accreditation at a time of rapid 
change, and that accreditation is a 
costly procedure. 

Miss Baumgart said the committee 
felt it was important to recognize that 
nursing is entering a crucial period of 
transition, and innovative approaches 
to education will be needed to prepare 
persons for changing nurse roles. At the 
same time continuing emphasis will 
have to be given to restructuring the 
institutions and curricula that serve 
nursing education. 

Goals and priorities listed by the 
committee are: promoting the orderly 
transition in basic nursing education 
from hospital sponsored schools to 
educational institutions; helping intro- 
duce new educational products into 
the work force; promoting the devel- 
opment of various patterns and routes 
whereby nurses can be prepared for 
specialist and extended roles or for 
work in rural, isolated or unusual prac- 
THE CANADIAN NURSE 35 



tice settings; clearly differentiating 
between the goals of diploma, bacca- 
laureate, and graduate education in 
nursing; promoting regional planning 
for development of nursing education 
programs; promoting the search for 
more efficient and economical ways of 
learning how to nurse; helping to ensure 
"that systematic attention is given in 
basic nursing education programs to 
learning to be a continuing learner and 
to developing skills in collaborating 
with health team members"; consider- 
ing ways and means of assisting nursing 
personnel to upgrade their educational 
qualifications. 

An armchair conference on nursing 
practice in the '70s was recommended 
in the report of the joint committee on 
nursing service and nursing education 
presented at the annual meeting by 
Irene Buchan, chairman of the commit- 
tee on nursing service, and Alice Baum- 
gart, chairman of the committee on 
nursing education. 

The conference was conceived as 
a "brain-storming session" to which 
will be invited "innovative thinkers 
about nursing including young active 
practitioners." This conference will 
focus on: the future of nursing practice 
within the context of changing health 
services; long-term goals for nursing 
in Canada; mechanisms for evolving 
long-term goals within the framework 
of CNA. The joint committee's recom- 
mendation was accepted by the CNA 
board at its sessions prior to the annual 
meeting. 

Also accepted by the board was the 
joint committee's resolution that the 
CNA support the undertaking by pro- 
vincial nursing associations of activi- 
ties with allied health organizations 
to determine long-range goals for health 
services including types of health serv- 
ices required; types of health service 
practitioners required; the education 
needs of present and future health prac- 
titioners. 

The board accepted in principle the 
36 THE CANADIAN NURSE 



need for development of a document 
which would contain: a philosophy of 
staff development; a definition of staff 
education, and its relationship to other 
forms of continuing education; a state- 
ment of functions of a staff education 
department; guidelines concerning how 
to proceed with the development of a 
staff education department; a state- 
ment concerning qualifications of staff 
education personnel; job description 
for staff education personnel. The board 
decided that the executive director, 
in consultation with the president, 
would approach a suitable person to 
develop such a document. 

The chairmen of the three standing 
committees stressed, at both the annual 
meeting and the board meeting, the 
shortcomings of the present standing 
committee structure. In a report. Miss 
Baumgart, Mrs. Brewer, and Miss Bu- 
chan said, "No longer does it seem 
possible for most issues on which deci- 
sions are needed to be neatly parceled 
into either education, or service, or 
social economic welfare. The present 
committees are costly in terms of pro- 
ductiveness and are often unable to 
respond expeditiously to matters re- 
quiring the attention of the association." 

The executive of CNA had asked 
the committee chairmen to prepare a 
paper on changing the organizational 
framework of the association. At two 
meetings of the committee chairmen, 
agreement was reached that a need to 
change the organizational framework 
of CNA existed and that this involved 
much more than simply changing the 
nature of the committee structure. 

The paper said, "New and more res- 
ponsive structures seem necessary to: 
continuously monitor what is happen- 
ing in relation to a wide range of social 
and nursing issues; define relevant long- 
term goals and set appropriate national 
priorities; respond quickly, decisively 
and knowledgeably to the diversity of 
public issues to which nursing expertise 
has relevance; provide for greater op- 



portunities for member participation 
in association affairs; ensure effective 
communications both within the pro- 
fession and to the outside." 

Other business 

Several delegates expressed con- 
cern that a French-speaking person 
had not yet been appointed by CNA 
to its senior staff, and recommended 
that a selections committee be set up 
io help find such a person. The execu- 
tive director reported she had approach- 
ed several nurses whose mother tongue 
was French, but had had little success 
in finding persons interested in consul- 
tant positions. She announced, however, 
that as of September 1, 1971, Sister 
Madeleine Bachand, whose first langua- 
ge is French, will join CNA staff as 
research analyst. 

A motion to set up an advisory panel 
on selections, to be called at the discre- 
tion of the executive director when 
senior positions are being filled, was 
approved by the delegates. It was agreed 
that this panel would serve to assist the 
executive director and would in no way 
take away her right to have the final 
decision when employing staff. 

Before adjourning the meeting, the 
president reminded members that the 
next annual meeting will be held in 
Edmonton, Alberta, from June 25 to 
28, 1972. * 



MAY 1971 



Nurses in prison 

If you are looking for a challenging and rewarding out-of-the-ordinary job, 
you might try signing into prison. 



Gwen Norens 

At least one warden in Canada would 
like to see more nurses in prisons. 

He is Warden Pierre Jutras of the 
Drumheller Medium Security Prison in 
central Alberta. Mr. Jutras in looking 
for good, qualified, mature nurses to 
staff his prison hospital and help pro- 
vide health care for the 400 prisoners at 
his federal penitentiary. 

Drumheller is one of the newer Ca- 
nadian penitentiaries and takes a differ- 
ent approach to the care of criminals. 
It is out to rehabilitate, not punish. 

"The guiding philosophy of the 
Drumheller Penitentiary focuses on 
endorsing a sense of confidence, self- 
respect, and dignity for the prisoners," 
says Warden Jutras. "It's not enough 
just to clamp a man in prison to punish 
him, hold him in custody for a number 
of years, then throw him out again 
saying 'Now function." " 

One of the warden's major reforms 
was a decision to send prisoners into 
the community on temporary leaves 
before they were released permanently 
or paroled. Under the Penitentiary Act, 
a warden has the power to grant leaves 
of up to three days as part of his reha- 
bilitative program, but until Warden 
Jutras tried it at Drumheller, these 
passes were rare. 

Drumheller began granting leaves, 
even to "hard-core" prisoners, for a 
number of reasons — to work in the 



Mrs. Norens, a registered nurse, is also 
a freelance writer. 



MAY 1971 



community, to visit families, to give 
them a chance to look for work and 
living accommodations before they are 
discharged. 

To date, Drumheller has given more 
than 5,000 temporary leaves and only 
once has a prisoner not returned. 

But the leaves are only one part of 
the reforms at Drumheller. It was even 
built along different lines, so it would 
look less like a fortress. 

It includes complete academic, vo- 
cational, and trades training facilities 
where prisoners can learn skills to help 
them fit better into society on their 
release. And it includes a 17-bed hos- 
pital and outpatient clinic that is also 
a part of the rehabilitative program. 

Mostly outpatient work 

John Savrtka, one of the three nurses 
on staff at the Drumheller Penitentiary 
during my visit, discussed the work 
being done by the hospital staff. He and 
the senior hospital officer, Stanley 
Baird, have been on staff since the 
opening of the prison in 1967. 

"It's not really just a hospital," said 
Mr. Savrtka. "It's also more of an out- 
patient approach." 

To him, it's like a community health 
service — except the community is 
bounded by a seven-foot fence and all 
the patients are men. 

Drumheller had two openings for 
nurses at the time of my visit, and the 
warden had made a break with federal 
penitentiary traditions and hired a 
woman. This has ^een done success- 
THE CANADIAN NURSE 37 




fully in provincial all-male prisons, but 
it was a pioneering event for a federal 
institution, especially at the medium 
security level. 

Since its opening in 1967, Drum- 
heller has hired women to work in the 
offices inside the prison block and was 
one of the first federal prisons to do 
this. 

But Warden Jutras is particular 
about the staff and is definite that he 
wants the best — the best-prepared and 
the best psychologically able to work 
with prisoners in what can be a tense 
situation. 

Also, the nurse must be one who 
agrees with the philosophy of rehabil- 
itation, not punishment. 

"We're short staffed at present be- 
cause the warden refuses to lower stand- 
ards," said Mr. Savrtka. "He could hire 
non-nursing staff who were poorly 
prepared, but he won't — and we agree 
because we, too, want the best." 

Mr Savrtka is a registered nurse 
a graduate of Alberta Hospital, Ponoka 
with an affiliation at the Calgary Gen- 
eral Hospital. After graduation, he 
worked for two years at the Calgary 
General, then moved to Drumheller 
his hometown. 

"I had a lot of responsibility and 
enjoyed working at the General — I 

38 THE CANADIAN NURSE 



worked mostly nights on an arthritic 
and coronary convalescent ward. Some 
patients came directly from the intensive 
care unit. But here, we have a greater 
responsibility — for the whole person." 

The hospital area, like the rest of 
the prison buildings, is a concrete mo- 
dern block. At first glance, the prison 
resembles a modern school building, 
but it isn't hard to see that it could be 
turned into a prison fortress within 
minutes in case of trouble. 

Inside, the clinic area looks like 
a modern outpatient area in some large 
hospital. There is a 17-bed nursing 
unit at the rear, but only eight or ten 
patients have been hospitalized at any 
one time. 

The hospital is self-contained in 
many respects. The front part contains 
offices, treatment rooms, a dispensary 
minor surgery, laboratory, dental office' 
ophthalmology clinic, x-ray room,' 
examining room, and two doctors' 
offices. 

A physician from the city of Drum- 
heller visits the clinic daily (Monday 
to Friday) for about two hours, a dentist 
comes out two mornings a week, an 
optometrist visits one afternoon a week 
and a psychiatrist from Calgary comes 
usually once every two or three weeks 
Consulting specialists, including a top 
ophthalmologist and dermatologist, 
come occasionally from Calgary on 
referrals from the general practitioners 
— usually about once a month when 
they are needed and if the patient can't 
be given a pass to visit them in their 
offices in Calgary. 

There is a full-time psychologist on 
the prison staff who works closely with 
the nursing staff. As well, the nurses 
work in close cooperation with other 
prison staff, including the officers in 
charge of the dormitory units, the teach- 
ing staff, and the social workers who 
work closely with the individual prison- 
ers at Drumheller. 



Healthy, but . . . 

Prisoners are given a routine physical 
examination as part of the prison ad- 
mission routine. At that time a list of 



health needs that should be attended 
to is drawn up. 

"On the whole, they're a pretty 
healthy group," Mr. Savrtka said. But 
many prisoners have health needs, such 
as dental caries, acne, or physical de- 
fects, which may be psychologically 
crippling and which can be corrected 
while they are in prison as part of their 
overall rehabilitative treatment. 

"For treatments of this kind, formal 
approval from the warden and the pa- 
tient are needed," Mr. Savrtka said. 
For example, a prisoner may benefit 
from corrective eye surgery. "Stra- 
bismus repairs are a common example." 
One of the social workers said, rather 
bitterly, that he thought physical defects 
often were partly responsible for forc- 
ing a young person who had neither 
the money nor the knowledge of how 
to get health services into criminal 
habits. 

Rehabilitative surgery also includes 
such things as removal of tatoos, plastic 
surgery to remove scars or correct hare 
lips, or cosmetic surgery to shorten or 
repair a too prominent nose. One of 
the most common cosmetic repairs is 
for the saddle nose deformity. 

In these latter cases, a thorough 
psychiatric assessment is done first. 

Minor surgery is performed in the 
prison hospital; major surgery is carried ' 
out in the general hospitals in Drum- 
heller or Calgary. Patients return to the 
prison for convalescent care. If neces- 
sary, physiotherapy can be carried out 
at the prison hospital or a patient may 
get leaves to visit the Drumheller city 
hospital. 

Some group therapy is carried on 
but at present the psychologist prefers 
to work on a one-to-one basis with the 
patients and to have the staff do so as 
well. 

"You can often do more on an indi- 
vidual one-to-one basis in a situation 
like this," said Mr. Savrtka. "And with 
such a relatively small number of pa- 
tients, you can get to know them well " 

It could be, too, that prison peer 
groups are not considered the best 
training groups for someone who is 



MAY 1Q71 




trying to break away from a life of 
crime. 

The nurses also get a fair amount of 
minor emergency work from the weld- 
ing and woodworking shops and the 
prison laundry and kitchen, all staffed 
by the prisoners. The prisoners have 
an active sports program and there are 
often minor treatments for football and 
1j;j: hockey injuries. 

Only a small number of prisoners 
are on medications, and they must 
make individual visits for each dose. 

"Maybe five percent at any one time 
]:};: might be receiving tranquilizers. We 
look for other ways to combat depres- 
sion and homesickness, two of our 
most common problems." 

Training programs 

The hospital unit also plays a part 
in the rehabilitative job-training pro- 
gram that is so important at Drum- 
heller. 

One of the prisoners works as an 
orderly, and officials are corresponding 
with Alberta's orderly training program 
to see if he can eventually qualify under 
that program, based on his work in the 
prison. 

As well, because Drumheller ar- 
ranges for work passes for prisoners 
so they can take jobs in the community 
even before they are released, there 
is a possibility a trainee might be able 
to work in the hospital in Drumheller. 

There are also two trainees in the 
dental assistant program. They get 
practical experience working with the 
dentist at the prison and in making and 
fitting dentures in the completely self- 
contained dental area. All plates for 
prisoners are made there. 

These two trainees would still need 
to take part of the course in one of the 
two main cities before they qualified 
for a certificate, but it may be possible 
that this could be done during their 
parole period. 

Mr Savrtka praised the trainee pro- 
gram with its greater emphasis on edu- 
cation for outside living and would 
like to see it extended even further. 

"The point is that they should be 



better individuals when they are released 
than when they are admitted." 

Good working conditions 

Mr. Savrtka said he would recom- 
mend the federal penitentiary service 
as an employer. 

"The salaries are comparable to 
those in the cities," he said. But he 
added that Drumheller, a small city 
well off the main highway between 
Calgary and Edmonton, is somewhat 
isolated. 

He said he finds it rewarding to 
perform a useful job for society as part 
of a team that works together for the 
good of everyone — prisoner and 
society. 

"You are given a good deal of per- 
sonal responsibility, too, and there is 
lots of room for initiative." 

Mr. Savrtka gives the warden credit 
for the reforms, as did all the other 
staff I interviewed. But the staff also 
know that the warden's methods are 
working. You cannot argue with sta- 
tistics — and these show that about 
40 to 50 percent of prisoners released 
from Canadian penitentiaries end up 
back behind bars. But at Drumheller, 
the average is about 1 5 to 17 percent. 

Mr. Savrtka said there has never 
been an instance when a prisoner turned 
on the nurse m the hospital area. 

"That doesn't mean I'd do something 
silly and tempt a patient into having a 
go. But there is a sense of trust here." 

He would also like to see more reg- 
istered nurses knocking on the prison 
doors trying to get in. 

"I wouldn't hesitate to have my wife, 
who is also an R.N., work here." § 




MAY 1971 



THE CANADIAN NURSE 39 



The research process 

The author describes the major activities inherent in the research process, point- 
ing out that "researching" is interesting and challenging, but requires infinite 
patience, self-discipline, and persistence. 



Loretta E. Heidgerken, R.N., Ed.D. 

Although nursing literature stresses 
research as an important activity for 
the nursing profession, many profes- 
sional nurses, even among those who 
have pursued graduate study, do not 
give it high priority. In a recent study 
on work values in nursing, activities 
relating to research, such as "Engage 
in Research," "Direct Research Pro- 
jects," received the lowest mean value 
of the 52 activities listed.^ 

Moreover, nurses who are interested 
in research frequently see research 
as being a desirable activity in and of 
itself, with little regard to its contribu- 
tion to nursing. Many problems in 
nursing practice are being ignored by 
nurse researchers because these nurses 
are so far removed from the realities 
and complexities of nursing. This is 
not to deny the nurse researcher the 
right to investigate research problems 
of interest to her, but rather to stress the 
need for nurse researchers to place 
priority on research on problems relat- 
ing to nursing practice. 



40 THE CANADIAN NURSE 



Dr. Heidgerken, known internationally as 
a nurse educator, researcher, and author 
of many books and articles, is Professor 
of Nursing Education at The Catholic 
University of America School of Nursing, 
Washington, D.C. This paper is adapted 
from an address she gave at the first 
national conference on research in nurs- 
ing practice, held at the .Skyline Hotel in 
Ottawa Fcbriiury lf>to 18. 1'>7I. 



Nursing, a newcomer to research, 
deals with complex phenomena. We 
might well learn from the experience 
of the natural sciences. We need more 
and better descriptive research to 
provide us with a strong and broad 
factual base from which to develop 
hypotheses leading to theories which 
can be tested and which will provide 
principles for practice. Naturally, the 
hypotheses will need to be continually 
tested and modified. 

In addition, the researcher in nurs- 
ing should be concerned not only with 
the study of nursing problems, but also 
about how the knowledge can be ef- 
fectively used in practice. It is possible 
to have nursing knowledge and yet 
not know how to use that knowledge 
effectively in practice. 

Using knowledge in practice re- 
quires a variety of judgments on the 
part of the practitioner: how to carry 
out nursing activities; when to use 
them or not to use them; and when 
to modify them to meet the needs of 
the patient in a particular situation. 
Practice and theory building are in- 
dependent yet interrelated; theory is 
used in practice and from practice 
new concepts come that will aid in 
further development of theory. 

The process of research 

The process of research involves 
critical thinking of a high order. Al- 
though essential elements can be iden- 
tified, the process is neither unified 

MAY 1971 



nor sequential. Rather, it includes 
innumerable errors, corrections, di- 
gressions, laborious trials, and the 
tedious process of continual evaluation 
and validation. 

The research process is usually des- 
cribed to include a series of activities 
that may be broadly identified as fol- 
lows: 1. exploring the problem area; 
2. selecting the focus for study and 
stating the specific purpose; 3. esta- 
blishing the importance of studying the 
selected focus; 4. conceptualizing the 
problem and deriving hypothesis(es); 
5. designing the study; 6. collecting 
the data; 7. analyzing and interpreting 
the data; 8. arriving at conclusions and 
making recommendations; and 9. writ- 
ing and publishing the report. 

These activities should not be consi- 
dered as necessarily rigid sequential 
steps in the research process. They 
do not necessarily occur in the order 
presented here, nor are all of them 
explicitly present in every research 
project. Some of these activities may 
be carried on simultaneously, some 
may need to be repeated a number of 
times in various phases of a research 
project, some studies may not be test- 
ing a hypothesis. However, knowing 
and carefully considering each of these 
activities will enhance the accuracy 
of the research. Neglecting any one of 
them may result in introducing a po- 
tential and hidden pitfall that may 
cause trouble at any point and, in fact, 
may actually endanger the soundness 
and success of the total research pro